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Bill Klaproth (Host): Thinking about bariatric weightloss surgery? Well, being informed by asking the right questions can help you achieve long-term success. And here to talk about the right questions to ask when considering weightloss surgery is Dr. Brian Bollo, a surgeon at Cayuga Medical Center. Dr. Bollo thank you for your time. So, first off, why is it important that a potential patient ask good questions when it comes to weightloss surgery?

Brian Bollo, MD (Guest): Well, thank you for having me. Yes, it is very important for patients to ask questions of any doctor, certainly of a surgeon and I would really certainly stress that patients should inquire if they will indeed benefit from weightloss surgery. Because it’s not just about losing weight. It’s also about resolution of obesity related diseases and the question we’d really want to zero in is for the patient to say will I benefit.

Host: Well, that makes a lot of sense and is very important because not only looking better and feeling better, but there are important health benefits to bariatric weightloss surgery and asking those questions and understanding that, very important. So, when it comes to figuring out the best weightloss procedure to undertake, what questions should someone be asking you?

Dr. Bollo: Well, we should have a discussion with these patients to consider what their needs are, what their goals are. We’d like to try to evaluate a patient’s obesity related diseases and their expectations. Part of the surgeon’s, part of the doctor’s work is to guide patients through their expectations to try to come out on the other end a happier and healthier person. So, the procedures we do at Cayuga Medical Center are the adjustable gastric banding, as well as the gastric bypass and the sleeve gastrectomy. And these three procedures pretty much mirror what’s done across the country. Now we do three procedures and because of that, it tells you that there’s no one right procedure. So, it’s really a case by case and getting to know the patient and knowing what their expectations and goals are as well as what their obesity related diseases are; help us make a decision on what is best for them.

Host: Well, that’s good to know. Needs, goals and expectations. And you were just talking about figuring that out so, what to expect before and after, kind of that patient journey of before figuring out what procedure is right, the actual procedure and after. So, thinking about that journey then, before and after; what questions should someone be asking?

Dr. Bollo: Well they could ask of their surgeon, they could ask again, I bring it up again, will I benefit from the weightloss surgery. Patients will want to say well these are my expectations, I’d like to have a healthier weight, I’d like to resolve my diabetes to some extent and the questions to the surgeons will be do you think we will meet these? And setting reasonable expectations is my job when I sit down with my patients. Additionally, patients are going to want to ask questions of their family to see if they have support intact at the home. Other things that patients are going to want to ask of a bariatric program and we don’t do this as an isolated surgeon-patient venture. This is something where there’s a team involved, and so patients are going to want to know what team is behind the surgeon and that’s something I know my partner here – my partners here at Cayuga Center for Metabolic and Bariatric Surgery are proud of how robust our support and the rest of the team are.

Host: And speaking of expectations, so critical, can you talk about expectations of maintaining weight loss after surgery?

Dr. Bollo: That’s a great question. It’s important to understand that obesity is a lifelong disease for patients and patients who do undergo weightloss surgery, bariatric surgery; this is not something where it’s a quick fix. We follow our patients regularly all throughout the life – their lifetime because we know that patients can regain weight and we have patients meet with dieticians regularly long after surgery. An important thing to know for patients is that almost everyone will regain some amount of weight. They won’t regain all their weight back hopefully, although it is possible and it’s important that patients go with the understanding that this is a lifestyle change that I’m going to make and I’m going to lose weight, but I’m going to have to keep the mindset of that this is a marathon and I’m going to have to keep going at it for the best results.

Host: And you continue to follow up with the patient after gastric bypass surgery with those lifestyle changes and diet and foods, is that correct? So, you provide that counseling and support long after the procedure.

Dr. Bollo: We do. We do focus on potential long-term complications that may occur with the weightloss patient. We also will regularly talk about other options if patients do happen to regain weight. We will have patients continue to meet with a Registered Dietician if it helps them. What’s interesting though is that patients will have their own kind of course. Everyone will have their own course of what they can and cannot eat, what they can tolerate, what they can’t afterwards. And everybody is different. You really have to tailor make it and you have to really listen to the patient who underwent the surgery. And that’s what we do regularly. It’s really important to keep that close follow up because we want long-term successes.

Host: Absolutely. That is the main goal. And Dr. Bollo you mentioned there’s a full team involved in the bariatric program. Who is all on that team and for someone listening who can they expect to be working with throughout their journey before and after the surgery?

Dr. Bollo: Well, the members of the team include surgeons, include Registered Dieticians, we include a medical doctor with bariatric training, we include nursing staff to have navigate through the process. We also have patients who have been through the process who facilitate with our support groups following as well. So, these are the roles of our different team members and we have multiple of all.

Host: Right, so, another good question to ask who is on the team and who am I going to be seeing throughout this journey. Dr. Bollo are there any other questions people should be asking you? I’m sure you get questions all the time. Do you ever say to yourself, boy everybody asks me this question but what they really should be asking is this question? Is there a question like that, that comes to mind that you wish people would ask you, but they normally don’t?

Dr. Bollo: That’s a good question. It’s funny, the first thing I thought of is that a lot of people always ask me about excess skin and that’s something where we don’t really need to address that in the early stages, but certainly we don’t mind. Every question is good. The question I feel like we don’t necessarily get asked enough is what can I expect going forward to – what physicians will I need to see going forward with this after this procedure. In other words, we like to focus on the resolution of symptoms and other disease states. How will that affect how I follow up with other doctors? We don’t see that much.

Host: Well, that’s great insight Dr. Bollo. Exactly what I was looking for so thanks for sharing that with us and thank you so much for your time today. We appreciate it and for more information please visit www.cayugamedicalassoicates.org, that’s www.cayugamedicalassoicates.org. This is To Your Health from Cayuga Medical Center. I’m Bill Klaproth. Thanks for listening.