September 25, 2025 • 35 mins
Centered on Health 9-25-25 - Current trends in weight-loss medications with Dr. Robert Farrell
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
It's now time for Centered on Health with Baptis' Help
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news radio eight
forty WHAS. I'm your host, doctor Jeff Tuvlin. We're joined
as always from the studio with our producer mister Jim
Finnho's on standby.
Speaker 1 (00:26):
To take your calls.
Speaker 2 (00:27):
And before I introduce our guest tonight, who is a
friend of our show, doctor Farrell, I want to let
everyone know about a new type of episode we're going
to be doing about once a month, where doctor Lindsey
Snow will be joining me and we're going to alternate
between a couple different shows.
Speaker 1 (00:41):
One called Chief Complaint.
Speaker 2 (00:43):
Where we're going to go over various different chief complaints
like constipation or shortness of air or chest pain, and
the other will be called the Doctor is In, where
we will answer your questions that you submit to us,
and if you go to the Whas, Facebook or X pages,
there'll be a QR code where you can scan in
any question and we'll be collecting them and answering them
(01:03):
live on the show tonight, we're talking about updates on
weight management, and as we've talked about before, Kentucky has
a thirty eight percent overweight percentage of our population, with
sixteen percent of at being kids, and Kentucky ranks at
the top of obesity in our country. And the number
of gastric weight loss surgeries has declined by about twenty
(01:26):
five percent in twenty twenty two in twenty twenty three,
coinciding with about one hundred and thirty two percent increase
in the use of these medications for weight loss, including
GLP one. So we want to welcome back our regular
on the show, doctor Robert Farrell, who is a bariatric
surgeon with the Baptist Hospital Medical Group. He attended UFL
(01:46):
for medical school and residency at Slough and fellowship at
the Carolinas Medical Center in Charlotte, North Carolina. Doctor Fair,
welcome back to our show. Thanks for having me, well,
we always love having you, and you know, this is
such a moving target in terms of what's happening in
the in the weight loss community, and we're so lucky
(02:07):
to have you to always be available to join us
on our show. So I want to just start by
getting your reactions to sort of what I mentioned at
the at the beginning of the show, what where are
things going with weight loss in terms of surgery versus medications.
Have you seen that changing in your practice.
Speaker 3 (02:27):
Yeah, we've certainly seen since the advent of the golp
one medications that certainly more patients are trying these medications
and you know, maybe trying.
Speaker 1 (02:39):
To avoid surgery. So and what we've.
Speaker 3 (02:45):
Seen though is really, you know, there are patients that
are appropriate for just the golp one medication or the surgery,
but a lot of patients that are having some of
the best success or patients that are really doing both.
So it's not just a surgical approach or a medicine approach,
but it's sort of doing both. Much like we would
do any type of surgery, whether it was you know,
(03:06):
heart surgery or orthopedic surgery, we would use medications and
surgery to give patients their best results.
Speaker 2 (03:12):
And I know we'll be kind of ducking and weaving
in and out of these topics as we kind of
go through our conversation, but tell us a little bit
about the range of what's considered to be overweight or
OBEs how are we classifying that these days? Are we
still using those terms? Are we using the b M? I?
How is the degree of our weight being measured in
(03:35):
the clinics these days?
Speaker 3 (03:38):
Yes, we're still using the BMI primarily, although it's sort
of old and antiquated.
Speaker 1 (03:43):
That's what we're using.
Speaker 3 (03:45):
Really, it's what insurances use so to get things paid for,
we got to do it. But if if patients have
BMI of thirty or or higher, they're considered overweight, I mean,
I'm sorry, they're considered obese. And then being my thirty
five or higher is considered morbidly a beasts And that's
what qualifies you for surgery.
Speaker 2 (04:06):
And I know that, you know you were trained both
in general surgery and then bariatrics, and bariatrics to me
seems like it's a little bit of a different beast.
I mean, we think of going to our surgeon with
our gallbladder, They take our gallbladder out and then we
don't really have to see that surgeon again. But by definition,
you know, you you build a relationship with patients. Is
that what drew you to this field or what in
(04:28):
bariatrics in particular drew.
Speaker 1 (04:30):
You to it?
Speaker 3 (04:33):
Yeah, you know, you know, a lot of people will
say bariatric surgeons. There is a little family medicine and
every bariatric surgeon. So you know, we do see our patients,
you know, really lifelong, and that's what we want to
see because you know, one of they have you know,
they have great successes, but two you know, we want
to see when there's you know, setbacks or when there's
(04:55):
you know, things are going in the wrong direction, so
we can catch it earlier. And then there is months
and that's needed on these patients. You know, we monitor
their labs every six months or every year, and patients
can get into macro and micro nutrient deficiencies that can
lead to health problems.
Speaker 1 (05:12):
So you know, I encourage all patients out.
Speaker 3 (05:14):
There, whether we've done your surgery or someone else have
done it, to get into see your surgeon or come
see us if you had it done somewhere else in
another state or another part of the country. We're always
happy to take transfer patients. Some places don't want to
do that, but you know, if you've relocated, we want
to give.
Speaker 1 (05:33):
Patients that option to come and see us.
Speaker 2 (05:37):
And you know, it's so great to have a provider
that you know takes on this sort of as a
holistic approach, because I think one of the things that's
kind of important to remind people is that the benefits
of this bariotric surgery is not just on weight loss.
I mean, what other kinds of health things have you
seen or that the studies show can improve with weight
(05:59):
loss surgery.
Speaker 1 (06:02):
Yeah, it's a head to toe disease.
Speaker 3 (06:06):
There's really not a body system that's not affected by
being overweight or obese, and they can't be made better
by having weight loss. So you know from patients that
suffer from obstructive sleepatnia, which is a big deal, or
high blood pressure diabetes, so if you're joint pain, you know.
Speaker 1 (06:28):
Those are things that readily come to mind.
Speaker 3 (06:30):
But also you know, cancer prevention, infertility, You know, there
are large groups of patients that you know, if they
could lose you know, thirty fifty, seventy, one hundred pounds whatever,
a lot of those problems can be mitigated or completely
can go away.
Speaker 2 (06:51):
And take us through kind of briefly the patient experience
if they come to see you in particular, or a
bariatric surgeon, how is the decision made that Okay, we
think it's time for surgery as opposed to lifestyle modifications
or these GLP ones, and like where how does that
decision get made in in the office.
Speaker 3 (07:16):
Yeah, so, I mean a lot of it is forming
a relationship with the patient and talking with patients and
trying to understand.
Speaker 1 (07:22):
What their goals are and what they want to have done.
Speaker 3 (07:25):
Maybe what they've tried in the past and what's failed,
you know. So that's that's sort of the first step
that we want to do. Because there's lots of patients
you know, that we can go in different directions based
off what they want to do. Again, some want to
try medicine, you know, because you know, maybe they've never
tried it. Some want to do just lifestyle medication, and
(07:47):
others have tried all those things and they want to
you know, move more towards surgery or you know some
form of of of of other.
Speaker 1 (07:54):
Therapy or treatment that we have.
Speaker 3 (07:56):
So we kind of try to lay all that out
and then you know, let them know what their options
are and then try to work towards you know, something
that they're.
Speaker 1 (08:05):
Going to believe in and that it's going to help
them to be successful.
Speaker 3 (08:09):
I really feel like if a patient doesn't if they
don't believe in what we're doing.
Speaker 1 (08:14):
It's not going to be It doesn't matter what stats
I have or what I tell them. They've got to
get behind it.
Speaker 3 (08:20):
They've got to believe in it because lifestyle modification will
be part of any treatment plan that we come up with.
Speaker 2 (08:27):
Well said, Well, we are just getting started with doctor
Robert Ferrell tonight about weight loss management and some new
advances in weight loss surgery. We are going to take
a short break. I want to let everybody know that
you are listening to Centered on Health with Baptist Health
here on news radio eight forty whas our phone number
five oh two five seven one eight four eighty four
(08:48):
five oh two, five seven one eight four eight four.
Do you want to call in and join the conversation.
We're talking to doctor Robert Ferrell about weight loss and
we will be right back. Welcome back to Senate on
(09:13):
Health with Baptist Health here on news radio eight forty WJS.
I'm your host, doctor Jeff Tevlin, and we're talking tonight
with doctor Robert Ferrell, who is a bariatric surgeon with
the Baptist Hospital Medical Group who's talking to us tonight
about weight loss and weight loss surgery. Our phone number
is five oh two, five seven one eight four eighty four,
and our producers on call to take your calls if
(09:33):
you want to ask a question or be a part
of our conversation. So, doctor Ferrel in general, you know,
I think we're starting to become familiar with you know,
when people talk about having had weight loss surgery, we
hear certain terms. We hear bypass, we hear sleeve, we
hear lack band. Like, give us a little bit of
(09:54):
a description of what these surgeries are and how they differ.
Speaker 1 (09:59):
In the way that they caused weight loss.
Speaker 3 (10:03):
Sure, So a lot ban was you know, the first
sort of surgery that was you know, was very popular
back you know, ten fifteen years ago, and everybody sort
of still refers to the lat band. I had a
lot band put in, or know, somebody had a lot
band put in.
Speaker 1 (10:23):
But what we came to find out what that surgery was.
Speaker 3 (10:26):
It was a restrictive device that went around the top
of the stomach and it literally almost was like like
a clamp that just prevented you from eating a certain
amount of food so that it sort of stopped you
got you full very quickly, and you know, patients did
well with those early on, but what we found is
as time went on, when they got out five, seven,
(10:47):
ten years out, they started having problems with regurgitation and
reflux and pain. And so mostly in our practice we
see patients that have had lat bands that want them
to take out and converted to a different surgery. So
there's not many lap bands being done in the country
anymore as a primary surgery.
Speaker 1 (11:09):
And then gas your bypass.
Speaker 3 (11:11):
Has been a surgery that's been around for many, many decades.
It's been modified here and there, it's still a popular surgery,
probably about twenty to twenty five percent of our practice.
Speaker 1 (11:24):
And in that.
Speaker 3 (11:24):
Surgery, we create a small stomach which we use.
Speaker 1 (11:29):
For what's called restriction.
Speaker 3 (11:30):
It restricts the amount of food you can eat, to
eat a small amount of food, and we also create
what's called malabsorption, where we take a section of your
bow and we bypass about half of your bow so
that you don't absorb as many fat or calories. So
the way it works us through both restriction and malabsorption.
(11:53):
And then the third surgery that you mentioned, the sleeve
gets stracted me it's sort of the middle ground. It's
just a restrictive only surgery, so we don't do any
malabsorption with a small bow, but we basically resect a
significant portion of a patient's stomach, so we create what
we call a banana shaped stomach, and patients end up
(12:16):
losing a significant amount of weight because they eat less,
and they obviously by eating less, they're not taking as
many as many calories.
Speaker 2 (12:29):
Welcome back to Center on Health with Baptistel here on
news radio eight forty WHS. I'm your host, doctor Jeff Paublin.
We're talking tonight with doctor Robert Ferrell, who's a bariatric
surgeon with the Baptist Hospital Medical Group. Our phone number
five seven one eight four eight four if you want
to call in and be a part of the show.
Doctor Ferrell, Are we back together.
Speaker 1 (12:51):
Yes, sir, I think so. All right.
Speaker 2 (12:54):
Well, I apologize for that little technical glitch there, But
right before I got cut out, we were talking a
little bit about the different types of surgeries and how
they cause weight loss. So if you could just talk
to us with that in mind, when you have a
patient in front of you, how how do you decide
which surgery is right for somebody?
Speaker 1 (13:16):
Yeah, that's a great question.
Speaker 3 (13:18):
I mean, you know, the first thing we want to
do is just sort of get a feel for, you know,
how much weight they want to lose, what kind of
comorbidities they have, such as high blood pressure or diabetes,
you know, what's their age, and that all sort of
kind of forms a story, and then based off that story,
you know, some patients would be good candidates for any
(13:40):
and all procedures we offer, and some would be better
suited for one in particular. Often I try, I don't
try to tell patients you have to have just this
or you have to have that.
Speaker 1 (13:51):
I like to give them options.
Speaker 3 (13:53):
I will tell them what I think is, you know,
from experience, what I think would work best. But again,
I really want the patients to get behind what they're
going to have done. I want them to believe in it,
because ultimately they're the ones that are going to have
to make the lifestyle changes, UH to make it work
to its fullest benefit.
Speaker 2 (14:14):
And we spoke a little bit earlier about the g
LP ones and I think, you know, there's kind of
a trend now that I don't think most of us
know much about, and you know, maybe you could shed
some light on you We're used to hearing about these injectibles,
but are are these medicines now available orally? And and
(14:34):
I think we've heard of the term micro doosting, like
what where's the trend going with these medicines.
Speaker 3 (14:41):
Yes, and this is a very this is an evolving
trend obviously, you know, it is started with lots of
people have heard about ozempic and now we go vi
and zep bound or majero, these are sort of trade names,
and those are all injectible forms of the GOLP one molecule.
(15:04):
And they have shown that, you know, it's the first
medicine in quite some time that has shown real meaningful
weight loss without having significant side effects for example like
fen fen that everybody heard about in the mid nineties
that caused heart valve damage and things like that. Not
(15:26):
to say that these medications can't have side effects, because
they can. They have to be monitored closely, but overall
very well tolerated if under a physician's care. And so
in terms of the injectable medications have been around for
an hour a couple of years, and there is a
bit of a race to develop an oral formulation of
(15:50):
either you know, we govi or a zep bound. Those
are made by Eli Lilly and Nova Nevartist, which are
the two pharmaceutical companies, and they're getting very very close.
Maybe the end of this year or the first part
of next year, we're gonna see some oral formulations of
these medications.
Speaker 2 (16:09):
And what does what does that term microdosing mean?
Speaker 3 (16:14):
Yeah, so a lot of times we will prescribe what's
called compounded GLP one medication. Thus, usually for patients you know,
whose insurance does not cover the the name brand medication.
So a compound is sort of like a generic version
of the medication, but it's we're able to prescribe this
(16:38):
and patients can purchase this at a at a reduced cost,
you know, usually at about one tenth of the cost.
And so when you know, when they use the compounded versions,
they actually have to draw up the amount of medication
they're given. They're given a chart and told how much
(16:58):
to give based off the the doses we put them on.
But microdosing is somewhat somewhere where patients are maybe doing
half dosing of what we prescribed and it's an effort
to sort of stretch out the medication to give them.
They'll get lower amounts of medication, but maybe just enough
that gives them, you know, that kind of keeps their
(17:20):
hunger at bay and allows them maybe to maintain a
certain amount of weight loss that they've had and also
maybe have lower side effects, but also at a reduced cost.
Speaker 1 (17:32):
So this is kind of the idea of microdosing.
Speaker 3 (17:34):
That's sort of you're starting to see a lot of
people talk about this.
Speaker 2 (17:38):
Yeah, I'm glad that we have you to help us
answer that. One of the things I'm very curious about is,
you know, there's this concept of pscitivism after surgery. To
you talk a little bit about that and how that
impacts what you see in your practice.
Speaker 3 (17:58):
Yes, I mean, wait, recidivism is a very real thing,
and I taught to patients both pre and post.
Speaker 1 (18:02):
Surgery about it.
Speaker 3 (18:04):
You know, we would love to say, you know, patient
comes and sees me, is gonna have surgery and lose
one hundred pounds or more, And we would love to
say that they're gonna go to that weight and stay
there for the rest of their life and nothing bad
is ever going to happen. But realistically we know that
that's not the case. Life happens. We have lots of
patients that they'll get pregnant. You know, they'll lose weight
and they'll be able to get pregnant, or you know,
(18:26):
they'll have stresses at home, they'll lose a job, or
they'll have a loved one get ill, and you know,
that leads to bad behaviors, and that sometimes leads to
weight regain. And that's what weight recidivism is. We saw
a whole bunch of patients during the COVID era. You know,
we did surgery. Patients were doing great, they were exercising,
(18:46):
they were eating well, and then all of a sudden,
their gyms were closed, they're sometimes they're you know, where
they were getting food was limited or they couldn't order
it or make it, and and basically a lot of
the habits that they had formed kind of went out
the window. And so we saw patients, you know, gravitate
back regain weight. And so we want to encourage patients
(19:11):
to say that's not necessarily you know, that's not a
failure on their part. I think often the medical community
or you know, has kind of put it out there like, hey,
you know that's some kind of failure. It's not a failure,
it's it's just you know, it's part of the process,
and we want to be there to help these patients,
you know, to say that we have a lot of
(19:32):
tools in our toolbox now, and you know, if you
start to regain some weight, you know, obviously the sooner
the better to get back in and see.
Speaker 1 (19:40):
But we can often help in those situations.
Speaker 2 (19:45):
So, doctor Farrell, we have Jill on the line, and
you know, Jill is gonna tell us a little bit
about her journey with her decisions about weight loss, and
I think it's a good example of things that patients
are going through. And then maybe you and I can
pick apart some of what is going on and maybe
talk about things people might expect from various types of surgery.
(20:07):
So I'm gonna I'm gonna ask Jill if you don't
mind sharing what you shared with me.
Speaker 4 (20:14):
Okay, Hi, I'm Jill. Really nice to talk to you all.
I just so in twenty twenty one, I chose to
have the gastric sleeve with a great bariatric doctor and
it worked great for me. I lost ninety two pounds.
But then all of a sudden, I because I was
(20:37):
reading things about taking proliseic every day, that maybe I
shouldn't take it anymore and maybe I won't have the problem.
So I stopped taking it and decided I would just
take pepsid if needed. And I don't know if it
was just a coincidence, but just all of a sudden,
my reflux got really bad. So my doctor and I
I was put on protonics in the morning prolosecond night.
(21:00):
During the day. I would sometimes sometimes have to take
pepsid three times a day, including times, and nothing would
control it. So his thought was that we would go
to the mini gastric bypass. I think that's the one
anastomosis and that and he would also fix my hyael
(21:21):
hernia and that that would relieve my reflux. And one
it did, and I'm so thankful for that. But uh,
I think what I did not and it's my fault.
Speaker 2 (21:35):
I'm a nurse.
Speaker 4 (21:35):
I should have done a lot more research, but I
don't think I really understood about malabsorption and the fact
that now I have I feel like I can't eat
almost anything but protein because it just goes straight through me.
So there's times that I don't eat at work the
(21:56):
majority of the day because I'm too afraid I'll have
to go to the bath room. Almost everything but protein
makes my stomach hurt. I can't have pretty much any
milk products anymore. So I'm having a lot of problems,
and so I didn't know if it's a possibility to
completely reverse the bypass or what would be options for
(22:20):
me to make this better, Doctor Ferrell.
Speaker 2 (22:24):
So before we jump to doctor Ferrell, first of all,
I really want to thank you for sharing that with us,
because in my opinion, this is real world. This is,
you know, taking the things that we talk about on
this show that we've had. We've had these conversations before
and we're really hearing you know, what you're living through.
So I guess for doctor Ferrell, maybe if you could
(22:45):
take us through the sleeve and the reflux and then
maybe talk about this one in asimosis, because I believe
that Baptist is one of the few places that's doing that.
So I'm going to turn it over to you, doctor Ferrell,
and Jill, thank you very much. Welcome.
Speaker 1 (23:02):
Sure.
Speaker 3 (23:02):
So I mean that's you know, great points made, and
like you said, this is real world. You know, the
fantasy land is that everybody has surgery and everybody does
perfect and nothing ever bad happens. But you know, when
you see patients and you're willing to keep following them,
you have to understand that there can be some speed
bumps that happen in the road, just like with any
(23:24):
medical care, and we have to be willing to address them,
and every patient is individualized and try to figure out
what's best for them. Sometimes when you have a sleeve guesstrectomy,
it turns your stomach from what we would call a
low pressure system into a high pressure system. And without
(23:46):
being able to really diagram it out, it's just you
have a very small stomach, so there's really nowhere for
the pressure to go.
Speaker 1 (23:54):
But it can cause reflux because of this.
Speaker 3 (23:59):
And sometimes when patients have a Heidle hernia, as Jill mentioned,
that can be a weakness at the top of your
stomach where your sophius comes in, and that sometimes you
can fix the heidel hernia and tighten the muscles up
around there and that can fix the problem. Other times,
you're gonna have to have a way to relieve the
high pressure, and one way to do that is by
(24:22):
creating this one an asmotic gastric bypass, where you bring
some small bow to the stomach and you create an
opening I describe the patient. It's almost like a trapdoor
in the floor and it allows food to empty down
through into the bow without having pressure.
Speaker 1 (24:43):
And then the added.
Speaker 3 (24:44):
Benefits so often it will it will help with reflux
because it won't be pressure anymore. And the added benefit
is you have malabsorption and so you lose additional weight.
So sometimes when patients have weight recidivism of the sleeve
will go to the one an as thematic gas or
bypass and they will be able to lose additional weight
(25:05):
or any of the weight that they put on because
of that. So it can be a good option, especially
if theysis are having problems with reflux or pain.
Speaker 1 (25:15):
Our weight regain.
Speaker 2 (25:17):
And this is something that you're doing at Baptist and
in this situation we heard this was sort of to
kind of help alleviate some symptoms. But the DNOVO option
for surgery in the first place, is it replacing standard
gastric bypass? Is it less invasive? What is the advantage
of it over what we've been doing for years.
Speaker 3 (25:40):
Yeah, I think it's another tool in the in the
in the in the toolbox. Really it's one on an asthmosis.
A traditional ruin wide gas or bypass that we've been
doing for years takes two inn astimosis and anytime the
whole you know, if there's a risk with the surgery,
the risk is the anastamosis has to heal if it
(26:01):
if it doesn't heal correctly, that's when there's problems. So
anytime you're doing one instead of two by you know,
by definition, you know, it's quote unquote safer.
Speaker 1 (26:11):
That's how patients kind of view it.
Speaker 3 (26:13):
And there's probably lesson could go wrong because you're only
focused at the one area that has to heal and
do well. So that's probably you know, but there are
patients that still, you know, we have patients that you know,
their mom or their sister or some family member has
had one sort or another, for example, a traditional gas
or bypass, and they've done great, and they it doesn't
(26:35):
matter what you tell them. They want to have a
traditional gas or bypass, and I think that's great, that's fine. Others,
you know, you know, they'll ask, you know, should I
have a sleeve or many bypass or a bypass, And
that's why we really have to have a discussion and
try to figure out, you know, what are their goals
and where do they see themselves going and then we
try to say, well, you know, this would probably be
(26:56):
the best surgery for you.
Speaker 1 (26:58):
At least you know, starting out to try this.
Speaker 2 (27:02):
And I'm sure this answer is not as straightforward as
I'm going to ask it, but as Jill was asking
about options when there are issues with a surgery, is
reversing a bypass an option?
Speaker 1 (27:17):
It is an option. It is an option, and we
can do that.
Speaker 3 (27:19):
We can reverse the mini gas or bypass, we can
reverse a full gas or bypass.
Speaker 1 (27:26):
You know, obviously, you know, we don't.
Speaker 3 (27:28):
Do the surgeries with the intent to have to reverse them,
but occasionally, you know, because of patient preference or symptoms,
we have to look at that and maybe that becomes
an option. What we really want to do is get
a patient in the best possible health that we can
get them in. And to get them there, you know,
we have to get them losing weight, but we have
to get them doing that properly, eating right, exercising, good lifestyle.
(27:54):
We don't want maladaptive eating. We don't want patients. You know,
I'll have patients coming and say, well, I'm only eating
five hundred calories a day, isn't that great? And I'm like,
that's not great's that's not adaptive eating.
Speaker 1 (28:04):
We don't want that. We want healthy eating.
Speaker 3 (28:07):
We want the right proportion of protein, carbohydrates, fats.
Speaker 1 (28:11):
You know, there's you know all this.
Speaker 3 (28:14):
You work with our dietitians to be able to set
up a diet that's what I would call a healthy diet,
in a long term sustainable diet.
Speaker 1 (28:25):
You get on some of these very fad diets, you know,
and patients.
Speaker 3 (28:29):
Will do them for a month or two, three months, whatever,
but they're not sustainable and your body will start to
really drag, it'll feel fatigued, and you know, ultimately in
the long run that's not good for patients.
Speaker 2 (28:44):
Well, we are learning about weight loss surgery and advances
in weight loss surgery with doctor Robert Ferrell. Tonight, we're
going to take a short break. You are listening to
Centered on Health with Baptists Health here on news radio
eight forty WHAS. I'm doctor Jeff Tublin. We'll be right
back after these messages. Just tell here on news radio
(29:35):
eight forty WTS. I'm your host, doctor Jeff Helban. We're
talking with doctor Robert Ferrell. Remember to download the iHeartRadio
app to re listen to all of our previous segments,
Doctor Ferrell, before we went on break, we were talking
all about these the different surgeries and the recidivism and
all of that. But we do have a caller on
the line who wanted to ask you about some new
(29:57):
way lost medications. If you're on the line, you are
on with doctor Farrell. O great, Hello, Hello there, Yes,
welcome to the show.
Speaker 5 (30:08):
Well, Fraser is coming out with a new drug and
I'm just wonder if you know anything about it and
can you give me some guidelines on how to lose
ten to fifteen pounds?
Speaker 2 (30:23):
Hello?
Speaker 1 (30:24):
Who did you?
Speaker 2 (30:25):
Who did you say? What's coming out with the new drug?
You were asking Paser pharmist Siza.
Speaker 6 (30:30):
So doctor Farrell, right, So Adviser is another one of
the companies that are all sort of in this race
to come out with these oral gop WANs that you know,
we'll be able to be scaled much faster.
Speaker 1 (30:48):
And at a at a cheaper cost. So that will
be up.
Speaker 3 (30:53):
That will be a good thing in terms of losing
ten to fifteen pounds. I think it starts with you know,
I think it starts with a healthy diet, and I
think it starts with trying to cut down on the
amount of processed food that we're having. I think it
comes down to cutting down on the carbohydrates, trying to
(31:13):
focus more on some more higher lean proteins, vegetables, and
then you know, really trying to you know, dedicate you know,
thirty to forty minutes a day to some kind of
cardio activity, whether that's walking, whether that's going to the gym,
whether it's swimming, bike riding. I tell patients we don't
(31:36):
have to make it that complicated. You know, walking is
very simple. It's not expensive pair of tennis shoes. We
can do it virtually all year round. Very very few times.
I get a lot of the excuses, it's too hot,
it's too cold, it's too wet, it's too rainy, it's
too windy. But ultimately, very few days in the Louisville
area that we can't get out and put a hat
(31:58):
and gloves on, or go out early in the morning
when it's hot and get a thirty or forty minute
walk in. It will make a tremendous difference for patients.
If you're consistent and you show up and you do
it day in and day out, you will see after
a two to three months period, you'll see an enormous difference.
Speaker 2 (32:17):
That's great advice. So, Harvey, I hope that that helps,
and thank you for calling in. Have a good night
at Harvey, and thank you so doctor Ferrell. In the
last moments that we have, I know this is going
to be just a little bit of a teaser for
what we'll probably talk about when we have you done.
But I know you mentioned earlier about one in asthmosis
and that word in asthmosis about connecting the bale together.
(32:40):
What's being done now in terms of bowel and astimosis
that you're excited about.
Speaker 3 (32:49):
Yeah, I mean traditionally in surgery when we do this
anasthmosis or connection, we're cutting, futuring stapling.
Speaker 1 (32:56):
That's sort of the traditional way of doing it.
Speaker 3 (32:58):
But we've been one of the few test sites in
the United States that's been able to use magnets where
we're able to put a magnet in a patient's stomach
and a magnet in their bow, and we're able to
connect the magnets together and we don't have to cut
the bow or shoot to the bow. The magnets will
create a hole and that magnet will then pass through
(33:22):
your gi tract and it will be a perfect, perfectly
sized and as demosis with decreased risks for bleeding, their
stricture or some of the things that can happen when
you're cutting and sewing. And so this is sort of
the new frontier that we're working on.
Speaker 1 (33:42):
And like I said, we're one of the few in
the United States.
Speaker 3 (33:46):
There's there's some a big practice in Canada that's sort
of kind of designed this technology, developed it, and I
think it's not in prime time now, but I do
see this coming where it will become more populer and
perhaps an option for a lot of patients.
Speaker 2 (34:03):
I mean, I'm just sitting here picturing the way you're
describing it. It just sounds fascinating and it's so exciting that
we're doing these things right in our community. Doctor Ferrell.
Once again, thank you for joining us tonight. I know
we had a few technical difficulties, but as always, you
jump right in there. You provide us with so much
information and we love having you as a regular on
our show. We'll continue to do so to talk about
(34:25):
weight management as well as the other surgical things that
you do in your procast. We appreciate you. I want
to thank everybody for calling in. Harvey and Jill and
I want to thank the listener, thank our producer, mister
Jim Fenn, and we will see you every Thursday night
for another sediment, and have a great weekend and a
wonderful rest of your evening. This program is for informational
(34:51):
purposes only and should not be relied upon as medical advice.
The content of this program is not intended to be
a substitute for professional medical advice, diagnosis, or treatment. This
show is not designed to replace a physician's medical assessment
and medical judgment.
Speaker 4 (35:06):
Always seek the advice of your physician with any questions
or concerns you.
Speaker 2 (35:11):
May have related to your personal health or regarding specific
medical conditions.
Speaker 4 (35:15):
To find a Baptist health provider, please visit Baptistealth dot com.
It's now time for Centered on Health with Baptis' Help
on use Radio. Wait forty WYJS Now, here's doctor Jeff Tumbler.
Speaker 2 (00:11):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news radio eight
forty WHAS. I'm your host, doctor Jeff Tuvlin. We're joined
as always from the studio with our producer mister Jim
Finnho's on standby.
Speaker 1 (00:26):
To take your calls.
Speaker 2 (00:27):
And before I introduce our guest tonight, who is a
friend of our show, doctor Farrell, I want to let
everyone know about a new type of episode we're going
to be doing about once a month, where doctor Lindsey
Snow will be joining me and we're going to alternate
between a couple different shows.
Speaker 1 (00:41):
One called Chief Complaint.
Speaker 2 (00:43):
Where we're going to go over various different chief complaints
like constipation or shortness of air or chest pain, and
the other will be called the Doctor is In, where
we will answer your questions that you submit to us,
and if you go to the Whas, Facebook or X pages,
there'll be a QR code where you can scan in
any question and we'll be collecting them and answering them
(01:03):
live on the show tonight, we're talking about updates on
weight management, and as we've talked about before, Kentucky has
a thirty eight percent overweight percentage of our population, with
sixteen percent of at being kids, and Kentucky ranks at
the top of obesity in our country. And the number
of gastric weight loss surgeries has declined by about twenty
(01:26):
five percent in twenty twenty two in twenty twenty three,
coinciding with about one hundred and thirty two percent increase
in the use of these medications for weight loss, including
GLP one. So we want to welcome back our regular
on the show, doctor Robert Farrell, who is a bariatric
surgeon with the Baptist Hospital Medical Group. He attended UFL
(01:46):
for medical school and residency at Slough and fellowship at
the Carolinas Medical Center in Charlotte, North Carolina. Doctor Fair,
welcome back to our show. Thanks for having me, well,
we always love having you, and you know, this is
such a moving target in terms of what's happening in
the in the weight loss community, and we're so lucky
(02:07):
to have you to always be available to join us
on our show. So I want to just start by
getting your reactions to sort of what I mentioned at
the at the beginning of the show, what where are
things going with weight loss in terms of surgery versus medications.
Have you seen that changing in your practice.
Speaker 3 (02:27):
Yeah, we've certainly seen since the advent of the golp
one medications that certainly more patients are trying these medications
and you know, maybe trying.
Speaker 1 (02:39):
To avoid surgery. So and what we've.
Speaker 3 (02:45):
Seen though is really, you know, there are patients that
are appropriate for just the golp one medication or the surgery,
but a lot of patients that are having some of
the best success or patients that are really doing both.
So it's not just a surgical approach or a medicine approach,
but it's sort of doing both. Much like we would
do any type of surgery, whether it was you know,
(03:06):
heart surgery or orthopedic surgery, we would use medications and
surgery to give patients their best results.
Speaker 2 (03:12):
And I know we'll be kind of ducking and weaving
in and out of these topics as we kind of
go through our conversation, but tell us a little bit
about the range of what's considered to be overweight or
OBEs how are we classifying that these days? Are we
still using those terms? Are we using the b M? I?
How is the degree of our weight being measured in
(03:35):
the clinics these days?
Speaker 3 (03:38):
Yes, we're still using the BMI primarily, although it's sort
of old and antiquated.
Speaker 1 (03:43):
That's what we're using.
Speaker 3 (03:45):
Really, it's what insurances use so to get things paid for,
we got to do it. But if if patients have
BMI of thirty or or higher, they're considered overweight, I mean,
I'm sorry, they're considered obese. And then being my thirty
five or higher is considered morbidly a beasts And that's
what qualifies you for surgery.
Speaker 2 (04:06):
And I know that, you know you were trained both
in general surgery and then bariatrics, and bariatrics to me
seems like it's a little bit of a different beast.
I mean, we think of going to our surgeon with
our gallbladder, They take our gallbladder out and then we
don't really have to see that surgeon again. But by definition,
you know, you you build a relationship with patients. Is
that what drew you to this field or what in
(04:28):
bariatrics in particular drew.
Speaker 1 (04:30):
You to it?
Speaker 3 (04:33):
Yeah, you know, you know, a lot of people will
say bariatric surgeons. There is a little family medicine and
every bariatric surgeon. So you know, we do see our patients,
you know, really lifelong, and that's what we want to
see because you know, one of they have you know,
they have great successes, but two you know, we want
to see when there's you know, setbacks or when there's
(04:55):
you know, things are going in the wrong direction, so
we can catch it earlier. And then there is months
and that's needed on these patients. You know, we monitor
their labs every six months or every year, and patients
can get into macro and micro nutrient deficiencies that can
lead to health problems.
Speaker 1 (05:12):
So you know, I encourage all patients out.
Speaker 3 (05:14):
There, whether we've done your surgery or someone else have
done it, to get into see your surgeon or come
see us if you had it done somewhere else in
another state or another part of the country. We're always
happy to take transfer patients. Some places don't want to
do that, but you know, if you've relocated, we want
to give.
Speaker 1 (05:33):
Patients that option to come and see us.
Speaker 2 (05:37):
And you know, it's so great to have a provider
that you know takes on this sort of as a
holistic approach, because I think one of the things that's
kind of important to remind people is that the benefits
of this bariotric surgery is not just on weight loss.
I mean, what other kinds of health things have you
seen or that the studies show can improve with weight
(05:59):
loss surgery.
Speaker 1 (06:02):
Yeah, it's a head to toe disease.
Speaker 3 (06:06):
There's really not a body system that's not affected by
being overweight or obese, and they can't be made better
by having weight loss. So you know from patients that
suffer from obstructive sleepatnia, which is a big deal, or
high blood pressure diabetes, so if you're joint pain, you know.
Speaker 1 (06:28):
Those are things that readily come to mind.
Speaker 3 (06:30):
But also you know, cancer prevention, infertility, You know, there
are large groups of patients that you know, if they
could lose you know, thirty fifty, seventy, one hundred pounds whatever,
a lot of those problems can be mitigated or completely
can go away.
Speaker 2 (06:51):
And take us through kind of briefly the patient experience
if they come to see you in particular, or a
bariatric surgeon, how is the decision made that Okay, we
think it's time for surgery as opposed to lifestyle modifications
or these GLP ones, and like where how does that
decision get made in in the office.
Speaker 3 (07:16):
Yeah, so, I mean a lot of it is forming
a relationship with the patient and talking with patients and
trying to understand.
Speaker 1 (07:22):
What their goals are and what they want to have done.
Speaker 3 (07:25):
Maybe what they've tried in the past and what's failed,
you know. So that's that's sort of the first step
that we want to do. Because there's lots of patients
you know, that we can go in different directions based
off what they want to do. Again, some want to
try medicine, you know, because you know, maybe they've never
tried it. Some want to do just lifestyle medication, and
(07:47):
others have tried all those things and they want to
you know, move more towards surgery or you know some
form of of of of other.
Speaker 1 (07:54):
Therapy or treatment that we have.
Speaker 3 (07:56):
So we kind of try to lay all that out
and then you know, let them know what their options
are and then try to work towards you know, something
that they're.
Speaker 1 (08:05):
Going to believe in and that it's going to help
them to be successful.
Speaker 3 (08:09):
I really feel like if a patient doesn't if they
don't believe in what we're doing.
Speaker 1 (08:14):
It's not going to be It doesn't matter what stats
I have or what I tell them. They've got to
get behind it.
Speaker 3 (08:20):
They've got to believe in it because lifestyle modification will
be part of any treatment plan that we come up with.
Speaker 2 (08:27):
Well said, Well, we are just getting started with doctor
Robert Ferrell tonight about weight loss management and some new
advances in weight loss surgery. We are going to take
a short break. I want to let everybody know that
you are listening to Centered on Health with Baptist Health
here on news radio eight forty whas our phone number
five oh two five seven one eight four eighty four
(08:48):
five oh two, five seven one eight four eight four.
Do you want to call in and join the conversation.
We're talking to doctor Robert Ferrell about weight loss and
we will be right back. Welcome back to Senate on
(09:13):
Health with Baptist Health here on news radio eight forty WJS.
I'm your host, doctor Jeff Tevlin, and we're talking tonight
with doctor Robert Ferrell, who is a bariatric surgeon with
the Baptist Hospital Medical Group who's talking to us tonight
about weight loss and weight loss surgery. Our phone number
is five oh two, five seven one eight four eighty four,
and our producers on call to take your calls if
(09:33):
you want to ask a question or be a part
of our conversation. So, doctor Ferrel in general, you know,
I think we're starting to become familiar with you know,
when people talk about having had weight loss surgery, we
hear certain terms. We hear bypass, we hear sleeve, we
hear lack band. Like, give us a little bit of
(09:54):
a description of what these surgeries are and how they differ.
Speaker 1 (09:59):
In the way that they caused weight loss.
Speaker 3 (10:03):
Sure, So a lot ban was you know, the first
sort of surgery that was you know, was very popular
back you know, ten fifteen years ago, and everybody sort
of still refers to the lat band. I had a
lot band put in, or know, somebody had a lot
band put in.
Speaker 1 (10:23):
But what we came to find out what that surgery was.
Speaker 3 (10:26):
It was a restrictive device that went around the top
of the stomach and it literally almost was like like
a clamp that just prevented you from eating a certain
amount of food so that it sort of stopped you
got you full very quickly, and you know, patients did
well with those early on, but what we found is
as time went on, when they got out five, seven,
(10:47):
ten years out, they started having problems with regurgitation and
reflux and pain. And so mostly in our practice we
see patients that have had lat bands that want them
to take out and converted to a different surgery. So
there's not many lap bands being done in the country
anymore as a primary surgery.
Speaker 1 (11:09):
And then gas your bypass.
Speaker 3 (11:11):
Has been a surgery that's been around for many, many decades.
It's been modified here and there, it's still a popular surgery,
probably about twenty to twenty five percent of our practice.
Speaker 1 (11:24):
And in that.
Speaker 3 (11:24):
Surgery, we create a small stomach which we use.
Speaker 1 (11:29):
For what's called restriction.
Speaker 3 (11:30):
It restricts the amount of food you can eat, to
eat a small amount of food, and we also create
what's called malabsorption, where we take a section of your
bow and we bypass about half of your bow so
that you don't absorb as many fat or calories. So
the way it works us through both restriction and malabsorption.
(11:53):
And then the third surgery that you mentioned, the sleeve
gets stracted me it's sort of the middle ground. It's
just a restrictive only surgery, so we don't do any
malabsorption with a small bow, but we basically resect a
significant portion of a patient's stomach, so we create what
we call a banana shaped stomach, and patients end up
(12:16):
losing a significant amount of weight because they eat less,
and they obviously by eating less, they're not taking as
many as many calories.
Speaker 2 (12:29):
Welcome back to Center on Health with Baptistel here on
news radio eight forty WHS. I'm your host, doctor Jeff Paublin.
We're talking tonight with doctor Robert Ferrell, who's a bariatric
surgeon with the Baptist Hospital Medical Group. Our phone number
five seven one eight four eight four if you want
to call in and be a part of the show.
Doctor Ferrell, Are we back together.
Speaker 1 (12:51):
Yes, sir, I think so. All right.
Speaker 2 (12:54):
Well, I apologize for that little technical glitch there, But
right before I got cut out, we were talking a
little bit about the different types of surgeries and how
they cause weight loss. So if you could just talk
to us with that in mind, when you have a
patient in front of you, how how do you decide
which surgery is right for somebody?
Speaker 1 (13:16):
Yeah, that's a great question.
Speaker 3 (13:18):
I mean, you know, the first thing we want to
do is just sort of get a feel for, you know,
how much weight they want to lose, what kind of
comorbidities they have, such as high blood pressure or diabetes,
you know, what's their age, and that all sort of
kind of forms a story, and then based off that story,
you know, some patients would be good candidates for any
(13:40):
and all procedures we offer, and some would be better
suited for one in particular. Often I try, I don't
try to tell patients you have to have just this
or you have to have that.
Speaker 1 (13:51):
I like to give them options.
Speaker 3 (13:53):
I will tell them what I think is, you know,
from experience, what I think would work best. But again,
I really want the patients to get behind what they're
going to have done. I want them to believe in it,
because ultimately they're the ones that are going to have
to make the lifestyle changes, UH to make it work
to its fullest benefit.
Speaker 2 (14:14):
And we spoke a little bit earlier about the g
LP ones and I think, you know, there's kind of
a trend now that I don't think most of us
know much about, and you know, maybe you could shed
some light on you We're used to hearing about these injectibles,
but are are these medicines now available orally? And and
(14:34):
I think we've heard of the term micro doosting, like
what where's the trend going with these medicines.
Speaker 3 (14:41):
Yes, and this is a very this is an evolving
trend obviously, you know, it is started with lots of
people have heard about ozempic and now we go vi
and zep bound or majero, these are sort of trade names,
and those are all injectible forms of the GOLP one molecule.
(15:04):
And they have shown that, you know, it's the first
medicine in quite some time that has shown real meaningful
weight loss without having significant side effects for example like
fen fen that everybody heard about in the mid nineties
that caused heart valve damage and things like that. Not
(15:26):
to say that these medications can't have side effects, because
they can. They have to be monitored closely, but overall
very well tolerated if under a physician's care. And so
in terms of the injectable medications have been around for
an hour a couple of years, and there is a
bit of a race to develop an oral formulation of
(15:50):
either you know, we govi or a zep bound. Those
are made by Eli Lilly and Nova Nevartist, which are
the two pharmaceutical companies, and they're getting very very close.
Maybe the end of this year or the first part
of next year, we're gonna see some oral formulations of
these medications.
Speaker 2 (16:09):
And what does what does that term microdosing mean?
Speaker 3 (16:14):
Yeah, so a lot of times we will prescribe what's
called compounded GLP one medication. Thus, usually for patients you know,
whose insurance does not cover the the name brand medication.
So a compound is sort of like a generic version
of the medication, but it's we're able to prescribe this
(16:38):
and patients can purchase this at a at a reduced cost,
you know, usually at about one tenth of the cost.
And so when you know, when they use the compounded versions,
they actually have to draw up the amount of medication
they're given. They're given a chart and told how much
(16:58):
to give based off the the doses we put them on.
But microdosing is somewhat somewhere where patients are maybe doing
half dosing of what we prescribed and it's an effort
to sort of stretch out the medication to give them.
They'll get lower amounts of medication, but maybe just enough
that gives them, you know, that kind of keeps their
(17:20):
hunger at bay and allows them maybe to maintain a
certain amount of weight loss that they've had and also
maybe have lower side effects, but also at a reduced cost.
Speaker 1 (17:32):
So this is kind of the idea of microdosing.
Speaker 3 (17:34):
That's sort of you're starting to see a lot of
people talk about this.
Speaker 2 (17:38):
Yeah, I'm glad that we have you to help us
answer that. One of the things I'm very curious about is,
you know, there's this concept of pscitivism after surgery. To
you talk a little bit about that and how that
impacts what you see in your practice.
Speaker 3 (17:58):
Yes, I mean, wait, recidivism is a very real thing,
and I taught to patients both pre and post.
Speaker 1 (18:02):
Surgery about it.
Speaker 3 (18:04):
You know, we would love to say, you know, patient
comes and sees me, is gonna have surgery and lose
one hundred pounds or more, And we would love to
say that they're gonna go to that weight and stay
there for the rest of their life and nothing bad
is ever going to happen. But realistically we know that
that's not the case. Life happens. We have lots of
patients that they'll get pregnant. You know, they'll lose weight
and they'll be able to get pregnant, or you know,
(18:26):
they'll have stresses at home, they'll lose a job, or
they'll have a loved one get ill, and you know,
that leads to bad behaviors, and that sometimes leads to
weight regain. And that's what weight recidivism is. We saw
a whole bunch of patients during the COVID era. You know,
we did surgery. Patients were doing great, they were exercising,
(18:46):
they were eating well, and then all of a sudden,
their gyms were closed, they're sometimes they're you know, where
they were getting food was limited or they couldn't order
it or make it, and and basically a lot of
the habits that they had formed kind of went out
the window. And so we saw patients, you know, gravitate
back regain weight. And so we want to encourage patients
(19:11):
to say that's not necessarily you know, that's not a
failure on their part. I think often the medical community
or you know, has kind of put it out there like, hey,
you know that's some kind of failure. It's not a failure,
it's it's just you know, it's part of the process,
and we want to be there to help these patients,
you know, to say that we have a lot of
(19:32):
tools in our toolbox now, and you know, if you
start to regain some weight, you know, obviously the sooner
the better to get back in and see.
Speaker 1 (19:40):
But we can often help in those situations.
Speaker 2 (19:45):
So, doctor Farrell, we have Jill on the line, and
you know, Jill is gonna tell us a little bit
about her journey with her decisions about weight loss, and
I think it's a good example of things that patients
are going through. And then maybe you and I can
pick apart some of what is going on and maybe
talk about things people might expect from various types of surgery.
(20:07):
So I'm gonna I'm gonna ask Jill if you don't
mind sharing what you shared with me.
Speaker 4 (20:14):
Okay, Hi, I'm Jill. Really nice to talk to you all.
I just so in twenty twenty one, I chose to
have the gastric sleeve with a great bariatric doctor and
it worked great for me. I lost ninety two pounds.
But then all of a sudden, I because I was
(20:37):
reading things about taking proliseic every day, that maybe I
shouldn't take it anymore and maybe I won't have the problem.
So I stopped taking it and decided I would just
take pepsid if needed. And I don't know if it
was just a coincidence, but just all of a sudden,
my reflux got really bad. So my doctor and I
I was put on protonics in the morning prolosecond night.
(21:00):
During the day. I would sometimes sometimes have to take
pepsid three times a day, including times, and nothing would
control it. So his thought was that we would go
to the mini gastric bypass. I think that's the one
anastomosis and that and he would also fix my hyael
(21:21):
hernia and that that would relieve my reflux. And one
it did, and I'm so thankful for that. But uh,
I think what I did not and it's my fault.
Speaker 2 (21:35):
I'm a nurse.
Speaker 4 (21:35):
I should have done a lot more research, but I
don't think I really understood about malabsorption and the fact
that now I have I feel like I can't eat
almost anything but protein because it just goes straight through me.
So there's times that I don't eat at work the
(21:56):
majority of the day because I'm too afraid I'll have
to go to the bath room. Almost everything but protein
makes my stomach hurt. I can't have pretty much any
milk products anymore. So I'm having a lot of problems,
and so I didn't know if it's a possibility to
completely reverse the bypass or what would be options for
(22:20):
me to make this better, Doctor Ferrell.
Speaker 2 (22:24):
So before we jump to doctor Ferrell, first of all,
I really want to thank you for sharing that with us,
because in my opinion, this is real world. This is,
you know, taking the things that we talk about on
this show that we've had. We've had these conversations before
and we're really hearing you know, what you're living through.
So I guess for doctor Ferrell, maybe if you could
(22:45):
take us through the sleeve and the reflux and then
maybe talk about this one in asimosis, because I believe
that Baptist is one of the few places that's doing that.
So I'm going to turn it over to you, doctor Ferrell,
and Jill, thank you very much. Welcome.
Speaker 1 (23:02):
Sure.
Speaker 3 (23:02):
So I mean that's you know, great points made, and
like you said, this is real world. You know, the
fantasy land is that everybody has surgery and everybody does
perfect and nothing ever bad happens. But you know, when
you see patients and you're willing to keep following them,
you have to understand that there can be some speed
bumps that happen in the road, just like with any
(23:24):
medical care, and we have to be willing to address them,
and every patient is individualized and try to figure out
what's best for them. Sometimes when you have a sleeve guesstrectomy,
it turns your stomach from what we would call a
low pressure system into a high pressure system. And without
(23:46):
being able to really diagram it out, it's just you
have a very small stomach, so there's really nowhere for
the pressure to go.
Speaker 1 (23:54):
But it can cause reflux because of this.
Speaker 3 (23:59):
And sometimes when patients have a Heidle hernia, as Jill mentioned,
that can be a weakness at the top of your
stomach where your sophius comes in, and that sometimes you
can fix the heidel hernia and tighten the muscles up
around there and that can fix the problem. Other times,
you're gonna have to have a way to relieve the
high pressure, and one way to do that is by
(24:22):
creating this one an asmotic gastric bypass, where you bring
some small bow to the stomach and you create an
opening I describe the patient. It's almost like a trapdoor
in the floor and it allows food to empty down
through into the bow without having pressure.
Speaker 1 (24:43):
And then the added.
Speaker 3 (24:44):
Benefits so often it will it will help with reflux
because it won't be pressure anymore. And the added benefit
is you have malabsorption and so you lose additional weight.
So sometimes when patients have weight recidivism of the sleeve
will go to the one an as thematic gas or
bypass and they will be able to lose additional weight
(25:05):
or any of the weight that they put on because
of that. So it can be a good option, especially
if theysis are having problems with reflux or pain.
Speaker 1 (25:15):
Our weight regain.
Speaker 2 (25:17):
And this is something that you're doing at Baptist and
in this situation we heard this was sort of to
kind of help alleviate some symptoms. But the DNOVO option
for surgery in the first place, is it replacing standard
gastric bypass? Is it less invasive? What is the advantage
of it over what we've been doing for years.
Speaker 3 (25:40):
Yeah, I think it's another tool in the in the
in the in the toolbox. Really it's one on an asthmosis.
A traditional ruin wide gas or bypass that we've been
doing for years takes two inn astimosis and anytime the
whole you know, if there's a risk with the surgery,
the risk is the anastamosis has to heal if it
(26:01):
if it doesn't heal correctly, that's when there's problems. So
anytime you're doing one instead of two by you know,
by definition, you know, it's quote unquote safer.
Speaker 1 (26:11):
That's how patients kind of view it.
Speaker 3 (26:13):
And there's probably lesson could go wrong because you're only
focused at the one area that has to heal and
do well. So that's probably you know, but there are
patients that still, you know, we have patients that you know,
their mom or their sister or some family member has
had one sort or another, for example, a traditional gas
or bypass, and they've done great, and they it doesn't
(26:35):
matter what you tell them. They want to have a
traditional gas or bypass, and I think that's great, that's fine. Others,
you know, you know, they'll ask, you know, should I
have a sleeve or many bypass or a bypass, And
that's why we really have to have a discussion and
try to figure out, you know, what are their goals
and where do they see themselves going and then we
try to say, well, you know, this would probably be
(26:56):
the best surgery for you.
Speaker 1 (26:58):
At least you know, starting out to try this.
Speaker 2 (27:02):
And I'm sure this answer is not as straightforward as
I'm going to ask it, but as Jill was asking
about options when there are issues with a surgery, is
reversing a bypass an option?
Speaker 1 (27:17):
It is an option. It is an option, and we
can do that.
Speaker 3 (27:19):
We can reverse the mini gas or bypass, we can
reverse a full gas or bypass.
Speaker 1 (27:26):
You know, obviously, you know, we don't.
Speaker 3 (27:28):
Do the surgeries with the intent to have to reverse them,
but occasionally, you know, because of patient preference or symptoms,
we have to look at that and maybe that becomes
an option. What we really want to do is get
a patient in the best possible health that we can
get them in. And to get them there, you know,
we have to get them losing weight, but we have
to get them doing that properly, eating right, exercising, good lifestyle.
(27:54):
We don't want maladaptive eating. We don't want patients. You know,
I'll have patients coming and say, well, I'm only eating
five hundred calories a day, isn't that great? And I'm like,
that's not great's that's not adaptive eating.
Speaker 1 (28:04):
We don't want that. We want healthy eating.
Speaker 3 (28:07):
We want the right proportion of protein, carbohydrates, fats.
Speaker 1 (28:11):
You know, there's you know all this.
Speaker 3 (28:14):
You work with our dietitians to be able to set
up a diet that's what I would call a healthy diet,
in a long term sustainable diet.
Speaker 1 (28:25):
You get on some of these very fad diets, you know,
and patients.
Speaker 3 (28:29):
Will do them for a month or two, three months, whatever,
but they're not sustainable and your body will start to
really drag, it'll feel fatigued, and you know, ultimately in
the long run that's not good for patients.
Speaker 2 (28:44):
Well, we are learning about weight loss surgery and advances
in weight loss surgery with doctor Robert Ferrell. Tonight, we're
going to take a short break. You are listening to
Centered on Health with Baptists Health here on news radio
eight forty WHAS. I'm doctor Jeff Tublin. We'll be right
back after these messages. Just tell here on news radio
(29:35):
eight forty WTS. I'm your host, doctor Jeff Helban. We're
talking with doctor Robert Ferrell. Remember to download the iHeartRadio
app to re listen to all of our previous segments,
Doctor Ferrell, before we went on break, we were talking
all about these the different surgeries and the recidivism and
all of that. But we do have a caller on
the line who wanted to ask you about some new
(29:57):
way lost medications. If you're on the line, you are
on with doctor Farrell. O great, Hello, Hello there, Yes,
welcome to the show.
Speaker 5 (30:08):
Well, Fraser is coming out with a new drug and
I'm just wonder if you know anything about it and
can you give me some guidelines on how to lose
ten to fifteen pounds?
Speaker 2 (30:23):
Hello?
Speaker 1 (30:24):
Who did you?
Speaker 2 (30:25):
Who did you say? What's coming out with the new drug?
You were asking Paser pharmist Siza.
Speaker 6 (30:30):
So doctor Farrell, right, So Adviser is another one of
the companies that are all sort of in this race
to come out with these oral gop WANs that you know,
we'll be able to be scaled much faster.
Speaker 1 (30:48):
And at a at a cheaper cost. So that will
be up.
Speaker 3 (30:53):
That will be a good thing in terms of losing
ten to fifteen pounds. I think it starts with you know,
I think it starts with a healthy diet, and I
think it starts with trying to cut down on the
amount of processed food that we're having. I think it
comes down to cutting down on the carbohydrates, trying to
(31:13):
focus more on some more higher lean proteins, vegetables, and
then you know, really trying to you know, dedicate you know,
thirty to forty minutes a day to some kind of
cardio activity, whether that's walking, whether that's going to the gym,
whether it's swimming, bike riding. I tell patients we don't
(31:36):
have to make it that complicated. You know, walking is
very simple. It's not expensive pair of tennis shoes. We
can do it virtually all year round. Very very few times.
I get a lot of the excuses, it's too hot,
it's too cold, it's too wet, it's too rainy, it's
too windy. But ultimately, very few days in the Louisville
area that we can't get out and put a hat
(31:58):
and gloves on, or go out early in the morning
when it's hot and get a thirty or forty minute
walk in. It will make a tremendous difference for patients.
If you're consistent and you show up and you do
it day in and day out, you will see after
a two to three months period, you'll see an enormous difference.
Speaker 2 (32:17):
That's great advice. So, Harvey, I hope that that helps,
and thank you for calling in. Have a good night
at Harvey, and thank you so doctor Ferrell. In the
last moments that we have, I know this is going
to be just a little bit of a teaser for
what we'll probably talk about when we have you done.
But I know you mentioned earlier about one in asthmosis
and that word in asthmosis about connecting the bale together.
(32:40):
What's being done now in terms of bowel and astimosis
that you're excited about.
Speaker 3 (32:49):
Yeah, I mean traditionally in surgery when we do this
anasthmosis or connection, we're cutting, futuring stapling.
Speaker 1 (32:56):
That's sort of the traditional way of doing it.
Speaker 3 (32:58):
But we've been one of the few test sites in
the United States that's been able to use magnets where
we're able to put a magnet in a patient's stomach
and a magnet in their bow, and we're able to
connect the magnets together and we don't have to cut
the bow or shoot to the bow. The magnets will
create a hole and that magnet will then pass through
(33:22):
your gi tract and it will be a perfect, perfectly
sized and as demosis with decreased risks for bleeding, their
stricture or some of the things that can happen when
you're cutting and sewing. And so this is sort of
the new frontier that we're working on.
Speaker 1 (33:42):
And like I said, we're one of the few in
the United States.
Speaker 3 (33:46):
There's there's some a big practice in Canada that's sort
of kind of designed this technology, developed it, and I
think it's not in prime time now, but I do
see this coming where it will become more populer and
perhaps an option for a lot of patients.
Speaker 2 (34:03):
I mean, I'm just sitting here picturing the way you're
describing it. It just sounds fascinating and it's so exciting that
we're doing these things right in our community. Doctor Ferrell.
Once again, thank you for joining us tonight. I know
we had a few technical difficulties, but as always, you
jump right in there. You provide us with so much
information and we love having you as a regular on
our show. We'll continue to do so to talk about
(34:25):
weight management as well as the other surgical things that
you do in your procast. We appreciate you. I want
to thank everybody for calling in. Harvey and Jill and
I want to thank the listener, thank our producer, mister
Jim Fenn, and we will see you every Thursday night
for another sediment, and have a great weekend and a
wonderful rest of your evening. This program is for informational
(34:51):
purposes only and should not be relied upon as medical advice.
The content of this program is not intended to be
a substitute for professional medical advice, diagnosis, or treatment. This
show is not designed to replace a physician's medical assessment
and medical judgment.
Speaker 4 (35:06):
Always seek the advice of your physician with any questions
or concerns you.
Speaker 2 (35:11):
May have related to your personal health or regarding specific
medical conditions.
Speaker 4 (35:15):
To find a Baptist health provider, please visit Baptistealth dot com.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.