baptist physician communication packet june/july 2014
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ÂTRANSCRIPT
Physician Communication Packet
June/July 2014
PHYSICIAN COMMUNICATION PACkeT
What’s Inside:
4– 12 Physician Introduction
Jacksonville Orthopaedic Institute Scott McGinley, MD Michael Yorio, MD
Baptist ENT Specialists Iman Naseri, MD, FACS
Baptist Rheumatology Samuel Kim, MD
Baptist Primary Care Elicia Roos, DO Toluope Adeyemo, MD
Baptist Hospitalist Team Ethan Molitch-Hou, MD, MPH Keely Fischbach, MD Christina Mathai, MD
13 – 14 YMCA/Baptist Health
Youth nutrition counseling
15 – 18 Baptist Center for Bariatrics
PHYSICIAN COMMUNICATION PACkeT
What’s Inside:
19 – 21 Baptist Infectious Diseases
Travel and Tropical Medicine Center
22 Baptist Neurology
New epilepsy treatments
23 – 25 Medical Staff
SHIELD Passwords
Baptist CareConnection
Link — June 2014 Link — July 2014
Baptist Briefs Link — June 2014
Link — July 2014
Welcome Dr. McGinleyOrthopaedic Surgeon, Jacksonville Orthopaedic Institute
Jacksonville Orthopaedic Institute is pleased to welcome Scott
McGinley, MD, to their Fleming Island/Clay Division.
Scott McGinley, MD, believes in caring for his patients by listening,
engaging, and regarding everyone like family. He enjoys treating
all injuries and orthopaedic conditions and is particularly interested
in knees, hands, the spine and arthritis.
His education and qualifications include:
• Medical Degree from University of Medicine and Dentistry of
New Jersey, Newark, NJ
• Residency in Orthopaedic Surgery, University of Medicine and
Dentistry of New Jersey, Newark, NJ
• Fellowship in Orthopaedic Sports Medicine, University of Florida
College of Medicine, Gainesville, FL
• Board-certified in orthopaedic surgery
To make an appointment with Dr. McGinley, please call 904.276.5776 or visit joi.net.
Jacksonville Orthopaedic Institute
Fleming Island/Clay Division
1845 Town Center Blvd.
Suite 405
Fleming Island, FL 32003
PHYSICIAN INTRODUCTION
Welcome Dr. YorioSports Medicine, Jacksonville Orthopaedic Institute
Jacksonville Orthopaedic Institute is pleased to welcome
Michael A. Yorio, MD, to their San Marco Division.
Michael A. Yorio, MD, believes that an active lifestyle is a healthy
lifestyle. His philosophy as a sports medicine physician is that
a moving body is a healthier body. Dr. Yorio enjoys helping his
patients achieve their goals and has special expertise in concussion
management, injury risk assessment and sports injuries.
His education and qualifications include:
• Medical Degree from SUNY Health Science Center at Syracuse
College of Medicine, Syracuse, NY
• Residency in internal medicine, Carolinas Medical Center,
Charlotte, NC
• Fellowship in primary care sports medicine, University of
Maryland Sports Medicine, Timonium, MD
• Board certified in internal medicine
• Board certified in sports medicine
To make an appointment with Dr. Yorio call, 904.391.6955 or visit joi.net.
Jacksonville Orthopaedic Institute
San Marco Division
1325 San Marco Boulevard
Suite 200
Jacksonville, FL 32207
Fax 904.393.2099
PHYSICIAN INTRODUCTION
Welcome Dr. NaseriOtolaryngologist, Baptist ENT Specialists
Baptist ENT Specialists welcomes Iman Naseri, MD, FACS.
Dr. Lawrence Lisska is pleased to have Dr. Naseri join him at
his Salisbury Road office. Dr. Naseri brings with him experience
and expertise in the diagnosis and management of rare and
challenging diseases. His clinical interests include the treatment
of various sinus and allergy disorders, minimally invasive surgery
of the skull base, thyroid disorders, obstructive sleep apnea, head
and neck oncology, and upper airway disorders.
His education and qualifications include:
• Medical degree from Medical University of South Carolina,
Charleston, SC
• Residency in otolaryngology, head and neck surgery, Emory
University, Atlanta, GA
• Fellowship in rhinology/skull base surgery, University of
Toronto, Toronto, CA
• Board certified in otolaryngology
BAPTIST
SPECIALISTS
To schedule an appointment with Dr. Naseri call, 904.281.0234 or fax, 904.281.0236
Baptist ENT Specialists 4130 Salisbury Road North Suite 1900Jacksonville, FL 32216
PHYSICIAN INTRODUCTION
Welcome Dr. Kim Rheumatologist, Baptist Rheumatology
Baptist Rheumatology is pleased to welcome Samuel Kim, MD, to its
practice downtown at the Reid Building.
Dr. Kim’s philosophy of care focuses on treating his patients like a
member of his own family. He engages his patients in conversation
and creates treatment plans tailored to their health needs. His
areas of expertise include rheumatoid arthritis, lupus, myositis and
fibromyalgia.
His education and qualifications include:
• Medical degree from Universidad Mayor de San Andres, Bolivia
• Residency in internal medicine Alameda County Medical Center,
Oakland, Calif.
• Fellowship in rheumatology, University of Texas Health Science
Center, San Antonio, Texas
• Board certified internal medicine
• Fluent in Korean and Spanish
To make an appointment with Dr. Kim please call, 904.396.8656.
Baptist Rheumatology DowntownReid Building1325 San Marco BoulevardSuite 502Jacksonville, FL 32207
Fax 904.396.8621
PHYSICIAN INTRODUCTION
Welcome Dr. RoosFamily Physician, Baptist Primary Care
Adam Dimitrov, MD, ArpithaKetty, MD, and Ronald Renuart, DO,
are pleased to welcome Elicia Roos, DO, to their practice at Baptist
Primary Care Ponte Vedra.
Through education and disease prevention, Dr. Roos helps her
patients create their own version of wellness. She strives to be a
good listener in order to establish the needs of her patients. Dr.
Roos sees patients of all ages. Some of her areas of expertise
include women’s health, skin procedures, holistic care and
preventive medicine.
Her education and qualifications include:
• Master degree of science in biology, Indiana University/Purdue
University, Indianapolis, IN
• Medical degree from Nova Southeastern College of Osteopathic
Medicine, Davie, FL
• Residency in family medicine, St. Vincent’s Family Medicine
Residency, Jacksonville, FL
To make an appointment with Dr. Roos please call, 904.273.6900 or visit baptistprimarycare.net.
Baptist Primary Care
Ponte Vedra
520 A1A North, Suite 101
Ponte Vedra Beach, FL 32082
Fax 904.273.9022
PhySiCiAN iNTRoDuCTioN
Welcome Dr. AdeyemoFamily Physician, Baptist Primary Care
Please join us in welcoming Tolulope Adeyemo, MD, who is now in
practice at Baptist Primary Care Mandarin South.
Dr. Adeyemo loves developing and building new relationships
with his patients. He believes in providing compassionate care
and listening to his patients’ concerns in order to provide quality
care. Some of his areas of expertise include chronic disease
management, diabetes, well woman exams and geriatrics.
His education and qualifications include:
• Medical degree from Meharry Medical College, Nashville, Tenn.
• Residency in family medicine, Palmetto Health/University of
South Carolina Family Medicine Residency, Columbia, S.C.
• Board certified in family medicine
To make an appointment with Dr. Adeyemo, please call 904.292.9033 or visit baptistprimarycare.net
Baptist Primary Care
Mandarin South
11261 San Jose Blvd
Jacksonville, FL 32223
fax: 904.292.4127
PHYSICIAN INTRODUCTION
Meet Dr. Molitch-HouHospitalist, Baptist Medical Center Jacksonville
Ethan Molitch-Hou, MD, MPH, has joined the Baptist Hospitalist
team and is practicing at Baptist Medical Center Jacksonville. As a
hospitalist, Dr. Molitch-Hou will work very closely with the patient,
their family and the patient’s physicians, both primary care and
specialists, so everyone knows and understands the care plan.
Dr. Molitch-Hou strives to provide his patients with a clear
communication of the disease and his decision-making process.
He believes in strong communication with the outpatient team to
ensure a smooth transition of care.
His education and qualifications include:
• Medical Degree from Feinberg School of Medicine,
Northwestern University, Chicago, IL
• Masters in Public Health from Feinberg School of Medicine,
Northwestern University, Chicago, IL
• Internship in internal medicine, University of Chicago Medical
Center, Department of Medicine, Chicago, IL
• Residency in internal medicine, University of Chicago Medical
Center, Department of Medicine, Chicago, IL
• Board certified in internal medicine
To contact Dr. Molitch-Hou, please call 904.348.0974
PHYSICIAN INTRODUCTION
Meet Dr. FischbachHospitalist, Baptist Medical Center Jacksonville
Keely Fischbach, MD, has joined the Baptist Hospitalist team and is
practicing at Baptist Medical Center Jacksonville. As a hospitalist, Dr.
Fischbach will work very closely with the patient, their family and the
patient’s physicians, both primary care and specialists, so everyone
knows and understands the care plan.
Her education and qualifications include:
• Master of Science in physiology and biology from Georgetown
University, Washington, DC
• Medical Degree from the University of South Florida, Tampa, FL
• Residency in internal medicine, University of South Florida,
Tampa, FL
To contact Dr. Fischbach, please call 904.348.0974.
PHYSICIAN INTRODUCTION
Meet Dr. MathaiHospitalist, Baptist Medical Center Jacksonville
Christina Mathai, MD, has joined the Baptist Hospitalist team and is
practicing at Baptist Medical Center Jacksonville. As a hospitalist,
Dr. Mathai will work very closely with the patient, their family and the
patient’s physicians, both primary care and specialists, so everyone
knows and understands the care plan.
Dr. Mathai takes pleasure in being at the bedside and caring for
her patients by building strong physician-patient relationships. She
believes in working with fellow physicians in order to best care for
the whole patient. Dr. Mathai is a big proponent of preventive care,
patient education and encourages patients to play an active role in
their own healthcare.
Her education and qualifications include:
• Medical Degree from St. Georges University School of Medicine,
Grenada, West Indies
• Residency in internal medicine, University of Florida Jacksonville
College of Medicine, Jacksonville, FL
To contact Dr. Mathai, please call 904.348.0974
PHYSICIAN INTRODUCTION
June 6, 2014 Dear Health Care Provider, It is shocking to learn that as of today 1 out of every 3 children in America is considered overweight or obese. Based on current trends, by the year 2030, 2 out of every 3 children born today will be obese by the time they graduate high school. Here at the YMCA of Florida’s First Coast, we believe that through knowledge, guidance and encouragement we can help our future leaders develop and realize their highest potential. This is why we invest in the education of our youth through all of the many camps and activities that the Y offers. And now for the first time, the Y is offering Youth Nutrition Consultations with our Registered Dietitians (RDN) who are highly experienced in youth nutrition education. During these consults, the RDN can estimate the child’s nutritional needs, suggest meal plans and discuss physical activity. The consult will be a personalized and interactive conversation between the child, caregiver (i.e. parent) and the RDN. Our goal is to help the child find a balance between home and school life to meet their health goals and set a foundation for future healthy living. For more information please call 904.854.2084 to get in touch with the First Coast YMCA’s Registered Dietitians. Please see the attached flyer for additional details. Sincerely,
Sue Dukes, DTR Director of Healthy Living Innovations: Nutrition & Obesity YMCA of Florida’s First Coast 12735 Gran Bay Parkway West, Suite 250 Jacksonville, FL 32258 [email protected]
Youth Nutrition Counseling
BROOKS YMCA
Private, one-hour individual consultations are available for children ages 2-17. COST Members - $45 Non-Members - $60
All children deserve to grow up carefree, but sometimes that can be difficult when health problems start to develop and get in the way of having fun. Many obesity issues can be curbed with the right diet and exercise, that’s why we’re making nutrition consultations available to our youth to help them start feeling like a kid again.
Visit the Welcome Center for more information or call SUE DUKES, DTR Director of Healthy Living Innovations: Nutrition & Obesity 904.854.2083
Treating obesity. Transforming lives. Bariatric surgery is the most effective treatment for morbid obesity and can improve or resolve medical problems related to obesity. — National Institutes of Health
B a p t i s t C e n t e r f o r B a r i at r i C s
M
Quality
• Recognized as an Accredited Bariatric Center of Excellence
• Board-certified, fellowship trained surgeons — more than 530 surgeries performed
• Minimally invasive approaches result in fewer complications, faster recoveries
• Outcomes for BMI reduction two years post surgery exceed the MBSAQIP benchmark
• Creating a new wing of the hospital dedicated to bariatrics
Comprehensive
• Perform the three most common types of bariatric surgery — tailor best option for each patient
• Multi-disciplinary team approach includes the primary care provider, bariatric surgeon, plastic surgeon, bariatric coordinator, clinical dietitians, psychologists, exercise specialists, dedicated nurses and trained hospital staff
• Comprehensive program is structured for sustained weight loss and lifelong success — includes long-term follow up and ongoing free support groups
Affordable
• Unlike other area programs, we do not charge a program fee — informational seminars, insurance assessment and support groups are free
• Low-interest financing options for hospital and surgery fees available for self-pay patients
Referrals and Consultations
Fax: 904.391.5451Phone: 904.202.SLIM (7546)Email: [email protected]: baptistbariatrics.com
Thank you for allowing us to care for your patients’ weight loss and bariatric surgical needs.
Craig Morgenthal, MD, FACS Office: 904.398.0033
Steven Hodgett, MD, FACSOffice: 904.398.0033
Candidates for Bariatric Surgery
• BMI greater than 40
• BMI greater than 35 with associated medical problems (type 2 diabetes, hyperlipidemia, hypertension)
• Note: FDA approved use of Lap Band in patients with BMI over 30 with co-morbidities
• Patient has attempted weight loss through behavioral modification or medical treatment
• Patient is committed to long-term lifestyle changes
Your Patient’s Journey
M
Free informational seminar
Insurance verification
First consultation with surgeon
Psychologicalevaluation
Support group before surgery
Counseling with registered dietitian
Medical clearances
Second consultation with surgeon
Surgery and recovery
Monthly support groups post-op
Baptist Center for Bariatrics
Procedure LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC SLEEVE GASTRECTOMY
LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS
Description An adjustable silicone ring (band) is placed around the top part of the stomach and creates a small pouch
The procedure works by removing 80% of the stomach and reducing the secretion of gastric hormones
The procedure creates a small gastric pouch and also bypasses the stomach and a portion of the small intestine
How does it work?
• Reduces amount of food that can be consumed
• Adjustments (fills) are made through the access port by adding saline solution; average 6 fills in the first year
• No alteration to digestive tract
• Reduces amount of food that can be consumed
• Reduces gastric hormones and sensation of hunger in many patients
• No alteration to digestive tract
• Reduces amount of food that can be consumed
• Reduces amount of calories and nutrients the body absorbs (controlled malabsorption)
Average weight loss
• 50% of excess weight • 1 pound/week in first year
• 50-70% of excess weight • 1-2 pounds/week in first year
• 60-70% of excess weight • 1-2 pounds/week for first year
Long-term nutrition
• Small portions of healthy food • High protein, low carb • No drinking with meals • Zero-calorie liquids only
• Small portions of healthy food • High protein, low carb • No drinking with meals • Zero-calorie liquids only
• Small portions of healthy food • High protein, low carb • No drinking with meals • Zero-calorie liquids only • Avoid sugar and fats to prevent
dumping*
Nutritional supplements
• Multivitamin • No routine labs
• Multivitamin • Vitamin B12 • Need routine labs at 3, 6 and 12
months post-op, then yearly
• Multivitamin • Vitamin B12 • Calcium and iron (higher chance
of nutritional deficiencies if don’t take)
• Need routine labs at 3, 6 and 12 months post-op, then yearly
What are the risks?
• Lowest chance of operative complications
• Possible complications include heart, lung, blood clots and infections
• 25-40% chance for re-operation by 10 years due to band slip, erosion, leak or port problem
• Inadequate weight loss • Easiest procedure to “cheat”
• Low risk of major complications such as bleeding, leakage or stricture
• Possible complications include heart, lung, blood clots and infections
• Possible stomach enlargement and need for re-operation, 10% chance or higher
• Highest chance of operative complications including bleeding, leaking or obstruction, less than 5% need re-operation
• Possible complications include heart, lung, blood clots and infections
• Possible nutritional deficiencies • No aspirin, NSAIDs or smoking
due to risk of marginal ulcer or stricture
Hospital stay Overnight 2 nights 2 nights
Time off work 1-2 weeks 1-2 weeks 2-3 weeks
Operation time 1 hour 1.5 hours 2 hours
Recommendations • Better results if patients enjoy participating in an exercise program and are disciplined in following nutrition guidelines
• Less effective for BMI over 50 • Safe for higher-risk patients • Procedure is reversible
• Good option for patients with type 2 diabetes and patients whose medical conditions preclude other procedures, such as anemia, Crohn’s disease, extensive prior surgery or frequent steroid use
• Safe for higher-risk patients • Procedure is not reversible
• Most effective weight loss for patients with a BMI of 35-55
• Good option for patients with BMI over 50, type 2 diabetes, severe heartburn, joint problems or exercise limitations
• Not recommended for higher-risk and elderly patients
• Procedure is reversible
* Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or “dumped” into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea.
Procedure LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC SLEEVE GASTRECTOMY
LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS
DescriptionAn adjustable silicone ring (band) is placed around the top part of the stomach and creates a small pouch
The procedure works by removing 80 percent of the stomach and reducing the secretion of gastric hormones
The procedure creates a small gastric pouch and also bypasses the stomach and a portion of the small intestine
How does it work?
• Reduces amount of food that can be consumed• Adjustments (fills) are made through the access port
by adding saline solution; average 6 fills in the first year
• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces gastric hormones and sensation of hunger
in many patients• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces the amount of calories and nutrients the body absorbs
(controlled malabsorption)
Average weight loss
• 50% of excess weight• 1 pound/week in first year
• 50‐70% of excess weight• 1‐2 pounds/week in 1st year
• 60‐70% of excess weight• 1‐2 pounds/week for 1st year
Long-term Nutrition
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only• Avoid sugar and fats to prevent dumping*
Nutritional Supplements
• Multivitamin • No routine labs
• Multivitamin• Vitamin B12• Need routine labs at 3, 6 and 12 months post‐op,
then yearly
• Multivitamin• Vitamin B12• Calcium and iron (higher chance of nutritional deficiencies if don’t take)• Need routine labs at 3, 6 and 12 months post‐op, then yearly
What are the risks?
• Lowest chance of operative complications• Possible complications include heart, lung, blood
clots and infections• 10-20% chance for re-operation by 10 years due
to band slip, erosion, leak or port problem• Inadequate weight loss• Easiest procedure to “cheat”
• Moderate chance of operative complications including bleeding or leaking
• Possible complications include heart, lung, blood clots and infections
• Newer procedure with 3‐5 year published outcomes• Possible stomach enlargement and need for
re‐operation, 10% chance or higher
• Highest chance of operative complications including bleeding, leaking or obstruction, less than 5% need re-operation
• Possible complications include heart, lung, blood clots and infections• Possible nutritional deficiencies• No aspirin, NSAIDs or smoking due to risk of marginal ulcer
or stricture
Hospital Stay Overnight (less than 1 day) 2 nights 2 nights
Time off Work 1-2 weeks 1-2 weeks 2-3 weeks
Operation Time 1 hour 1.5 hours 2 hours
Recommendations
• Better results if patients enjoy participating in an exercise program and are disciplined in following nutrition guidelines
• Less effective for BMI over 50• Safe for higher-risk patients• Procedure is reversible • Many insurance companies will authorize
this procedure
• Good option for patients with type 2 diabetes and patients whose medical conditions preclude other procedures, such as anemia, Crohn’s disease, extensive prior surgery or frequent steroid use
• Safe for higher-risk patients• Procedure is not reversible• Several insurance companies will authorize
this procedure
• Most effective weight loss for patients with a BMI of 35‐55• Good option for patients with BMI over 50, type 2 diabetes,
severe heartburn, joint problems or exercise limitations• Not recommended for higher-risk and elderly patients• Procedure is reversible• Many insurance companies will authorize this procedure
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
Baptist Center for BariatricsC o m p a r i s o n C h a r t
To learn more about the Baptist Center for Bariatrics, visit e-baptisthealth.com/bariatrics or call 904.202.SLIM (7546).
* Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or “dumped” into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea.
Procedure LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC SLEEVE GASTRECTOMY
LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS
DescriptionAn adjustable silicone ring (band) is placed around the top part of the stomach and creates a small pouch
The procedure works by removing 80 percent of the stomach and reducing the secretion of gastric hormones
The procedure creates a small gastric pouch and also bypasses the stomach and a portion of the small intestine
How does it work?
• Reduces amount of food that can be consumed• Adjustments (fills) are made through the access port
by adding saline solution; average 6 fills in the first year
• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces gastric hormones and sensation of hunger
in many patients• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces the amount of calories and nutrients the body absorbs
(controlled malabsorption)
Average weight loss
• 50% of excess weight• 1 pound/week in first year
• 50‐70% of excess weight• 1‐2 pounds/week in 1st year
• 60‐70% of excess weight• 1‐2 pounds/week for 1st year
Long-term Nutrition
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only• Avoid sugar and fats to prevent dumping*
Nutritional Supplements
• Multivitamin • No routine labs
• Multivitamin• Vitamin B12• Need routine labs at 3, 6 and 12 months post‐op,
then yearly
• Multivitamin• Vitamin B12• Calcium and iron (higher chance of nutritional deficiencies if don’t take)• Need routine labs at 3, 6 and 12 months post‐op, then yearly
What are the risks?
• Lowest chance of operative complications• Possible complications include heart, lung, blood
clots and infections• 10-20% chance for re-operation by 10 years due
to band slip, erosion, leak or port problem• Inadequate weight loss• Easiest procedure to “cheat”
• Moderate chance of operative complications including bleeding or leaking
• Possible complications include heart, lung, blood clots and infections
• Newer procedure with 3‐5 year published outcomes• Possible stomach enlargement and need for
re‐operation, 10% chance or higher
• Highest chance of operative complications including bleeding, leaking or obstruction, less than 5% need re-operation
• Possible complications include heart, lung, blood clots and infections• Possible nutritional deficiencies• No aspirin, NSAIDs or smoking due to risk of marginal ulcer
or stricture
Hospital Stay Overnight (less than 1 day) 2 nights 2 nights
Time off Work 1-2 weeks 1-2 weeks 2-3 weeks
Operation Time 1 hour 1.5 hours 2 hours
Recommendations
• Better results if patients enjoy participating in an exercise program and are disciplined in following nutrition guidelines
• Less effective for BMI over 50• Safe for higher-risk patients• Procedure is reversible • Many insurance companies will authorize
this procedure
• Good option for patients with type 2 diabetes and patients whose medical conditions preclude other procedures, such as anemia, Crohn’s disease, extensive prior surgery or frequent steroid use
• Safe for higher-risk patients• Procedure is not reversible• Several insurance companies will authorize
this procedure
• Most effective weight loss for patients with a BMI of 35‐55• Good option for patients with BMI over 50, type 2 diabetes,
severe heartburn, joint problems or exercise limitations• Not recommended for higher-risk and elderly patients• Procedure is reversible• Many insurance companies will authorize this procedure
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
Baptist Center for BariatricsC o m p a r i s o n C h a r t
To learn more about the Baptist Center for Bariatrics, visit e-baptisthealth.com/bariatrics or call 904.202.SLIM (7546).
* Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or “dumped” into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea.
Procedure LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING
LAPAROSCOPIC SLEEVE GASTRECTOMY
LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS
DescriptionAn adjustable silicone ring (band) is placed around the top part of the stomach and creates a small pouch
The procedure works by removing 80 percent of the stomach and reducing the secretion of gastric hormones
The procedure creates a small gastric pouch and also bypasses the stomach and a portion of the small intestine
How does it work?
• Reduces amount of food that can be consumed• Adjustments (fills) are made through the access port
by adding saline solution; average 6 fills in the first year
• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces gastric hormones and sensation of hunger
in many patients• No alteration to digestive tract
• Reduces amount of food that can be consumed• Reduces the amount of calories and nutrients the body absorbs
(controlled malabsorption)
Average weight loss
• 50% of excess weight• 1 pound/week in first year
• 50‐70% of excess weight• 1‐2 pounds/week in 1st year
• 60‐70% of excess weight• 1‐2 pounds/week for 1st year
Long-term Nutrition
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only
• Small portions of healthy food• High protein, low carb• No drinking with meals• Zero-calorie liquids only• Avoid sugar and fats to prevent dumping*
Nutritional Supplements
• Multivitamin • No routine labs
• Multivitamin• Vitamin B12• Need routine labs at 3, 6 and 12 months post‐op,
then yearly
• Multivitamin• Vitamin B12• Calcium and iron (higher chance of nutritional deficiencies if don’t take)• Need routine labs at 3, 6 and 12 months post‐op, then yearly
What are the risks?
• Lowest chance of operative complications• Possible complications include heart, lung, blood
clots and infections• 10-20% chance for re-operation by 10 years due
to band slip, erosion, leak or port problem• Inadequate weight loss• Easiest procedure to “cheat”
• Moderate chance of operative complications including bleeding or leaking
• Possible complications include heart, lung, blood clots and infections
• Newer procedure with 3‐5 year published outcomes• Possible stomach enlargement and need for
re‐operation, 10% chance or higher
• Highest chance of operative complications including bleeding, leaking or obstruction, less than 5% need re-operation
• Possible complications include heart, lung, blood clots and infections• Possible nutritional deficiencies• No aspirin, NSAIDs or smoking due to risk of marginal ulcer
or stricture
Hospital Stay Overnight (less than 1 day) 2 nights 2 nights
Time off Work 1-2 weeks 1-2 weeks 2-3 weeks
Operation Time 1 hour 1.5 hours 2 hours
Recommendations
• Better results if patients enjoy participating in an exercise program and are disciplined in following nutrition guidelines
• Less effective for BMI over 50• Safe for higher-risk patients• Procedure is reversible • Many insurance companies will authorize
this procedure
• Good option for patients with type 2 diabetes and patients whose medical conditions preclude other procedures, such as anemia, Crohn’s disease, extensive prior surgery or frequent steroid use
• Safe for higher-risk patients• Procedure is not reversible• Several insurance companies will authorize
this procedure
• Most effective weight loss for patients with a BMI of 35‐55• Good option for patients with BMI over 50, type 2 diabetes,
severe heartburn, joint problems or exercise limitations• Not recommended for higher-risk and elderly patients• Procedure is reversible• Many insurance companies will authorize this procedure
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
ComparisonofBariatricSurgicalProcedures
Procedure
LAPAROSCOPIC
ADJUSTABLEGASTRICBANDING
LAPAROSCOPIC
SLEEVEGASTRECTOMY
LAPAROSCOPIC
ROUX‐EN‐YGASTRICBYPASS
Description
Anadjustablesiliconering(band)isplaced
aroundthetoppartofthestomachand
createsasmallpouch
Theprocedureworksbyremoving80
percentofthestomachandreducingthe
secretionofgastrichormones
Theprocedurecreatesasmallgastric
pouchandalsobypassesthestomachand
aportionofthesmallintestine
Howdoesitwork?
• Reducesamountoffoodthatcanbe
consumed
• Adjustments(fills)aremadethroughthe
accessportbyaddingsalinesolution,
average6fillsinthe1styear
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducesgastrichormonesandsensation
ofhungerinmanypatients
• Noalterationtodigestivetract
• Reducesamountoffoodthatcanbe
consumed
• Reducestheamountofcaloriesand
nutrientsthebodyabsorbs(controlled
malabsorption)
Averageweightloss• 50%ofexcessweight
• 1pound/weekin1styear
• 50‐70%ofexcessweight
• 1‐2pounds/weekin1styear
• 60‐70%ofexcessweight
• 1‐2pounds/weekfor1styear
Long‐termNutrition
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Smallportionsofhealthyfood
• Highprotein,lowcarb
• Nodrinkingwithmeals
• Zerocalorieliquidsonly
• Avoidsugarandfatstoprevent
dumping*
Nutritional
Supplements
• Multivitamin
• Noroutinelabs
• Multivitamin
• VitaminB12
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
• Multivitamin
• VitaminB12
• Calciumandiron(higherchanceof
nutritionaldeficienciesifdon’ttake)
• Needroutinelabsat3,6and12months
post‐op,thenyearlythereafter
Whataretherisks?
• Lowestchanceofoperative
complications
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• 10‐20%chanceforreoperationby10
yearsduetobandslip,erosion,leakor
portproblem
• Inadequateweightloss
• Easiestprocedureto“cheat”
• Moderatechanceofoperative
complicationsincludingbleedorleak
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Newerprocedurewith3‐5year
publishedoutcomes
• Possiblestomachenlargementandneed
forre‐operation,10%chanceorhigher
• Highestchanceofoperative
complicationsincludingbleed,leakor
obstruction,lessthan5%need
reoperation
• Possiblecomplicationsincludeheart,
lung,bloodclotsandinfections
• Possiblenutritionaldeficiencies
• Noaspirin,NSAIDs,orsmokingdueto
riskofmarginalulcerorstricture
• Stomachpouchmaystretchandleadto
weightregain
HospitalStay Overnight(lessthan1day) 2nights 2nights
TimeoffWork 1‐2weeks 1‐2weeks 2‐3weeks
OperationTime 1hour 1.5hours 2hours
Recommendations
• Betterresultsifpatientsenjoy
participatinginanexerciseprogramand
aredisciplinedinfollowingnutrition
guidelines
• LesseffectiveforBMIover50
• Safeforhigherriskpatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
• Goodoptionforpatientswithtype2
diabetesandpatientswhosemedical
conditionsprecludeotherprocedures
suchasanemia,Crohn'sdisease,
extensivepriorsurgeryorfrequent
steroiduse
• Safeforhigherriskpatients
• Procedureisnotreversible
• Severalinsurancecompanieswill
authorizethisprocedure
• Mosteffectiveweightlossforpatients
withaBMIof35‐55
• GoodoptionforpatientswithBMIover
50,type2diabetes,severeheartburn,
jointproblemsorexerciselimitations
• Notrecommendedforhigherriskand
elderlypatients
• Procedureisreversible
• Manyinsurancecompanieswill
authorizethisprocedure
* Alsocalledrapidgastricemptying,dumpingsyndromeoccurswhentheundigestedcontentsofyourstomacharetransportedor"dumped"intoyoursmall
intestinetoorapidly.Commonsymptomsincludeabdominalcrampsandnausea.
Baptist Center for BariatricsC o m p a r i s o n C h a r t
To learn more about the Baptist Center for Bariatrics, visit e-baptisthealth.com/bariatrics or call 904.202.SLIM (7546).
* Also called rapid gastric emptying, dumping syndrome occurs when the undigested contents of your stomach are transported or “dumped” into your small intestine too rapidly. Common symptoms include abdominal cramps and nausea.
baptistbariatrics.com904.202.SLIM (7546)
Meet our bariatric surgeons Our goal is to provide your patients with safe, consistent, quality care that helps enhance and extend their lives.
B a p t i s t C e n t e r f o r B a r i at r i C s
Craig Morgenthal, MD, FACS
“ We guide our patients by encouraging a healthy lifestyle, providing a proven bariatric surgery tool and supporting them with a comprehensive program. Together, this is the framework for long-term success.”
• Medical director of Baptist Center for Bariatrics
• Board-certified general surgeon and fellow of the American College of Surgeons
• Attended medical school at Tel Aviv University, completed his general surgery residency at the State University of New York at Brooklyn, and did a research and clinical fellowship in minimally invasive and bariatric surgery at Emory University School of Medicine
• Office: 904.398.0033
Steven Hodgett, MD, FACS
“ What I appreciate most about being a bariatric physician is developing personal relationships with each patient.”
• Board-certified bariatric surgeon with advanced training in weight loss surgery and laparoscopic surgery
• Attended medical school at the Medical College of Wisconsin in Milwaukee, completed his residency in general surgery at the University of South Florida School of Medicine and completed a clinical fellowship in minimally invasive surgery at Washington University School of Medicine in St. Louis, Missouri
• Office: 904.398.0033
Referrals and Consultations
Fax: 904.391.5451Phone: 904.202.SLIM (7546)Email: [email protected]: baptistbariatrics.com
Thank you for allowing us to care for your patients’ weight loss and bariatric surgical needs.
Meet Dr. AllenPhysician, Baptist Infectious Diseases
The physicians of Baptist Infectious Diseases are pleased to
welcome James Allen, MD, PhD, to their Baptist Medical Center
Jacksonville practice.
Dr. Allen has extensive experience in all areas of infectious
diseases. He has a special expertise in travel and tropical
medicine and has served as a medical missionary in Peru, Ecuador,
Honduras, Costa Rica, Kenya and Nepal. He is excited to bring his
expertise to the Northeast Florida community.
His education and qualifications include:
• Doctor of Medicine from the University of Miami, Miami,FL
• Residency in Internal Medicine, Loyola University Medical
Center, Maywood, IL
• Fellowship in Infectious Diseases, University of Colorado,
Denver, CO
• Board-certified Internal Medicine
• Board-certified Internal Medicine sub-specialty
Infectious Diseases
• Certificate in Knowledge in Tropical Medicine and
Travelers Health
• Certificate in Travel Medicine
To make an appointment with Dr. Allen, please call 904.396.4886.
Baptist Infectious Diseases
820 Prudential Drive
Suite 515
Jacksonville, FL 32207
PHYSICIAN INTRODUCTION
A travel medicine and infectious diseases expert, James Allen, MD, PhD, consults with his patients to provide valuable information that is customized to their health needs and travel itinerary.
James Allen, MD, PhD, is board-certified in Infectious Diseases and Internal Medicine, with a PhD in microbiology. He has earned a Certificate of Knowledge in Clinical Tropical Medicine and Travelers’ Health through the American Society of Tropical Medicine and Hygiene and a Certificate in Travel Health from the International Society of Travel Medicine.
Dr. Allen provides them with valuable information, about
the following:
Country specific health informationCountry specific immunization recommendationsMalaria prevention - medicines and repellentsCountry specific diseasesFood and water precautionsTraveler’s diarrhea - prevention and treatment Health advice for women/pediatric travelersHigh altitude illness Deep vein thrombosisCDC Travel Notices U.S. Deptartment of State Travel Warnings and AlertsInternational travel information
IntroducingBaptist Travel and Tropical Medicine CenterJames Allen, MD, PhD - Medical Director
FAQs:
Q. If all of my immunizations are up to date, why should I see a travel medicine physician?
A: A consultation equips you with important health information about the region you are traveling to. A travel medicine physician can review recommended and required immunizations with your personal health status in mind. A travel medicine physician will also be able to review the risks of immunizations and possible interactions with your other medications.
Q: How far in advance of my trip should I get my vaccina-tions?
A: At least two months prior to your trip because some immunizations take time to complete. But some shots, like hepatitis A, can be taken right up to your departure date. It is a good idea to plan as far ahead as possible, but check with a travel clinic before even a last minute trip.
Q: Will my health insurance cover the cost of travel health preparation like vaccinations?
A: Not usually. Because many health insurers view travel as a choice, they believe that an individual should be respon-sible for his or her medical preparation. Some medications and immunizations may be covered under special circum-stances. You may want to look into purchasing medical insurance that will cover you for the days you are traveling.
Pricing:
Consult fee: $50 individual, $70 family, $35 each 2 or more
Medication Administration fee: $36 for 1st injection, $42
for 2 or more injections
To schedule a Travel Consultation or to learn more, please contact Dr. Allen’s office at 904.396.3336. For more information please visit www.baptistjax.com
“ I have served as a medical missionary in Peru, Ecuador, Honduras, Costa Rica, Kenya and Nepal. As a result of my experiences, I gained extensive knowledge and a passion for tropical and travel medicine which I enjoy sharing with others.”
- James E. Allen, MD, PhD
Baptist Health offers new treatment for epilepsy patientsPatients with epilepsy whose seizures are not well controlled with medication may be good candidates for Vagus Nerve Stimulation (VNS). Syed Asad, MD, a neurologist with Baptist Neurology, is offering this proven technology for patients who have tried more traditional treatments yet still have seizures.
More than three million Americans have epilepsy and as many as one-third are unable to control their seizures with medications alone. Many patients taking medication experience side effects, such as extreme weight loss or gain, fatigue, lack of concentration, irritability, nausea and mood and vision changes. For these patients, alternative treatments, such as VNS, may be an excellent option.
VNS therapy works by implanting a device in the chest that sends mild electrical impulses to the brain via the vagus nerve in the neck. It is often referred to as a “pacemaker” for the brain.
VNS therapy comes with a magnet that, when swiped over the site of the implant, can prevent or lessen a seizure. The procedure is performed by a neurosurgeon and takes between 45 minutes to an hour. It is less invasive than brain surgery and most patients are able to leave the hospital the same day they have the procedure.
Because VNS Therapy is a non-drug option, it does not involve the typical side effects associated with anti-seizure medications. Some common side effects may include voice alteration, tickling in the throat, cough and a feeling of shortness of breath. Most patients say these side effects usually occur only when the device is stimulating the vagus nerve and often diminish over time. The majority of patients with VNS therapy continue with the treatment and report that seizure control improves over time. To date, more than 70,000 patients worldwide have received VNS Therapy and been able to enjoy greater confidence and freedom from the control of their seizures as a result.
Patients with at least one of the following may be candidates for VNS therapy:
• Uncontrolled seizures after trying at least two different anti-seizure medications
• Low quality of life
• Difficulty learning
• Many hospital admissions related to seizures
• Negative side effects from drugs
• Noncompliance in taking medications
• Frequent use of rescue medications
• Ineffective polypharmacy
• Those who are not good surgical candidates
• Those whose seizures are not localized
• Those who do not wish to have brain surgery
• Those who have experience surgical failure of relapse
• Those who have not had success with a ketogenic diet for seizure control
To make a referral to Dr. Asad, call 904.398.5404 or fax, 904.391.5545.
Meet Dr. Asad
Syed Asad, MD, received his medical degree from Dow University of Health Sciences in Pakistan and completed his Neurology training at Emory University Hospital in Atlanta. His training also included residencies at Harvard Medical School Joint Program of Nuclear Medicine in Boston; the University of Nebraska College of Medicine; and St. Elizabeth’s Medical Center in Boston. He is board certified in both neurology and nuclear medicine. He specializes in headache, nuclear medicine and neuroimaging. He has a special interest in movement disorders and deep brain stimulator programming.
B A P T I S T N E U R O L O G Y
Password Reset
FAQ
What if I forget my new password?
• Please call either the Baptist Health Service Desk at 202.7565, or the CPOE
support at 202.CPOE (2763)
• OR; If you are a Baptist Employed Physician AND on campus Baptist facility
or office (i.e. on the Baptist network) Password reset self-service may be
utilized. Please Note: Selfserve password reset tool will soon be
available to non-Baptist Health employees.
From the Baptist Health home page:
1. Click on “Apps
& Tools “
2. Select “Password
Reset Tool“
3. Password Reset
“Selfserve” will
open. Follow the
onscreen
prompts. (Note: Date of Birth
and last four of SSN
will be requested)
If you have any questions or concerns contact the Service Desk at 202-7565 or [email protected]
To: Baptist Jacksonville, South, Beaches, and Nassau Physicians and Allied Health Practitioners
From: Jerry Bridgham, MD, CMO, Wolfson Children’s Hospital
Keith L. Stein, MD, CMO, Baptist Health
Louis E. Penrod, MD, CMIO, Baptist Health
Subject: All User Passwords Must Expire Every 90 Days
In January 2014, Baptist Health implemented new stronger password requirements for user accounts.
However, some accounts are still not configured for password expiration. Beginning July 9th, Baptist Health
will begin reviewing all user accounts to ensure they are configured for password expiration every 90 days.
This process will take about two months. Groups that will be most heavily impacted are physicians, nurses
and other clinical staff.
This will affect the password used for SHIELD (Cerner Millennium), Allscripts, Physicians Portal, PeopleSoft,
PC or Laptop, Tap In Tap Out and Single Sign On, VPN, Email and Outlook Web.
How will this impact me?
• If your password is already expiring every 90 days you will not be impacted in any way.
• If your password is not expiring every 90 days it will be configured to do so. This change
will occur sometime over the twelve week period starting July 9
If my password currently does not expire, what can I do to change this on my own?
Change your password. If you change your password you will automatically be enrolled in the 90 day
password expiration.
Will I receive any kind of notification before my password expires?
Yes. When logging into a PC or laptop, you will receive notification each day if your password is within 10
days of expiring. However, you will not receive advance notification when logging in any other way, including
Outlook Web, VPN, TITO, and the Physician Portal.
How will I know when my password has expired?
You will be prompted to change your password when you log in to a PC or laptop, the Outlook Web
application, the Physician’s Portal or a Tap In Tap Out machine.
What if I forget my new password? (Please see attached FAQ)
Employees at any Baptist Health facility or office should:
• Go to any PC, launch Internet Explorer (which should open to the Baptist Health Intranet)
• Click on Apps & Tools at the top of the page
• Click on Password Reset Tool in the middle of the page
• Select Password Reset and follow on-screen instructions
Non-employees and employees not at a Baptist Health location should call the Service Desk at 202-7565.
Please Note: Selfserve password reset tool will soon be available to non-Baptist Health employees.
Memorandum
If you have any questions or concerns contact the Service Desk at 202-7565 or [email protected]
How will my mobile device connected to Baptist email be affected by an expired password?
Your mobile device should prompt you for your password. DO NOT enter any passwords because it has
expired and nothing you enter will work. You will need to:
• Log in to your PC/laptop or log in to the Physician’s Portal, Outlook Web, or Tap In Tap Out machine
and change password
• Enter that new password into your mobile device. IMPORTANT: if you forget to update your
password on a mobile device it will continue automatically try your old password which will result in
locking your user account
• If you have multiple mobile devices configured to connect to your Baptist email, you will need to
update each device with the new password
For additional details, please see the Baptist Health Intranet or the Physician’s Portal. If you need
assistance, contact the Baptist Health Service Desk at 202-7565 or [email protected].