Restoring Casey & Jim's Hearing with Cochlear Implants

Transcript

• 00:00[Calm music]
• 00:05- Folks will gain weight slowly over time,
• 00:09and it may start early on in life or it may start later in life.
• 00:13They finally get to a weight
• 00:15that their body,
• 00:16although it is unhealthy at that weight,
• 00:18is comfortable at that weight
• 00:20and to try to drive their weight down
• 00:22with diet and exercise doesn't work,
• 00:24the body fights it
• 00:26and at that point,
• 00:27we're dealing with a disease,
• 00:29the disease of obesity.
• 00:32Our basic primitive drives are,
• 00:34when faced with high-calorie food to consume it,
• 00:36even if at that particular time,
• 00:39we don't need the calories.
• 00:41The willpower is really not useful
• 00:44when you try and use it to curtail basic instincts.
• 00:46It just doesn't work.
• 00:47- It's really a disease.
• 00:48We know that this is mediated by hormones in the body,
• 00:51which promote weight gain in some people
• 00:54and don't allow for weight loss.
• 00:56- We all have a certain spectrum,
• 00:57a range where we fall in
• 00:59and you can affect that range.
• 01:00You can be above and below that range,
• 01:02but you are set in a certain precondition
• 01:05that's based on your own body history,
• 01:07your family history, your own physiology.
• 01:09- To treat obesity, you need to treat it like a disease with medical therapy.
• 01:16- I never gave a second thought to what I was eating.
• 01:19I was pretty skinny my whole life,
• 01:21and it just gradually crept up on me.
• 01:25- Even as a teen, I never really had
• 01:27a good image of myself
• 01:29and when I started gaining weight
• 01:30it just really made that a lot worse.
• 01:33- Clearly nutrition is very important but
• 01:35people become obese through a combination of many different factors.
• 01:39- [Laurie] Your body gets comfortable at a certain weight
• 01:42and my body was comfortable at 240 pounds.
• 01:45- [John] People would refer to me as Big John.
• 01:48I'd never thought of myself in those terms,
• 01:50but that was kind of sobering.
• 01:52- [Laurie] I didn't realize how big I was,
• 01:54'cause I didn't feel that big,
• 01:55but when I saw pictures,
• 01:57I just didn't recognize myself
• 01:59and I'm like, I really need to do something about it
• 02:02because I'm heading into my 40s soon,
• 02:04and I really want to just be healthy.
• 02:07- At my heaviest, I still took the stairs two at a time,
• 02:10but the difference was,
• 02:11when I got to the top of the stairs,
• 02:13I was winded, my heart was pounding.
• 02:16My doctor said I was pre-diabetic.
• 02:19That really scared me.
• 02:21That was the catalyst that really
• 02:24spurred me into action.
• 02:27- [Dr. Mehal] There are a multitude of health risks,
• 02:29heart disease, diabetes,
• 02:31high blood pressure,
• 02:32fatty liver disease
• 02:34and, at the end of the day,
• 02:35it affects mortality.
• 02:37People become obese through a multitude of different routes,
• 02:40and they lose weight through a multitude of different routes.
• 02:43It's a question of identifying very early on for patients
• 02:46what might be the best intervention.
• 02:48- [Dr. Hubbard] We know that many people are trying,
• 02:50and they lose weight and they gain it back.
• 02:52They yo-yo up and down.
• 02:54If I could take that same effort and apply it after surgery,
• 02:57when we know we've changed those hormones,
• 03:00it gives the patient a tool to use their hard work to achieve their weight loss goals.
• 03:06- [Dr. Nadzam] Bariatric surgery is a broad term.
• 03:08In essence, it is any operation that helps surgically reduce weight.
• 03:13There are two main bariatric surgeries performed.
• 03:17That would be a gastric sleeve or a gastric bypass.
• 03:20We do them laparoscopically
• 03:22with small incisions and long instruments.
• 03:24With surgery we are able to drive the weight down for long enough
• 03:30that now their body is comfortable back at a weight that is more reasonable.
• 03:35This is a disease that we treat surgically,
• 03:37but that afterward is treated in a multi-disciplinary approach.
• 03:42It's part surgery and part patient
• 03:44and I tell patients that all the time.
• 03:46- [Laurie] It's not a free pass.
• 03:47You really have to work on it to maintain your weight.
• 03:51- [Dr. Nadzam] Patients will lose more than half
• 03:53of all of the weight they're gonna lose
• 03:55in the first three months after surgery.
• 03:58- We would like to wait until at least a year,
• 04:00when a patient is close to their new low weight
• 04:03before we'd approach skin removal surgery.
• 04:07- [Dr. Alperovich] When you go through these operations,
• 04:09your body transforms.
• 04:10You are a different person at the end of the surgery.
• 04:13So it's hard to take on this new, healthier persona
• 04:16when you have this daily reminder of how you used to look.
• 04:19Part of it is aesthetic, but a lot of it is just quality of life.
• 04:23So a lot of the people who seek body contouring
• 04:25just want to return to normalcy.
• 04:30- [John] My highest weight loss was 145 pounds
• 04:33in eight or nine months.
• 04:36- It is nice to see them now,
• 04:38two-and-a-half years out from their surgeries,
• 04:40maintaining phenomenal weight loss.
• 04:43- [John] When I look at us now,
• 04:44we just seem so much happier and full of life
• 04:47and I don't think you can put a price on
• 04:49feeling wonderful about yourself
• 04:51and looking at yourself and saying,
• 04:52yeah, I look good.
• 04:54- [Dr. Nadzam] With weight loss surgery,
• 04:56we know that we're adding
• 04:57years back onto people's lives
• 04:59and that's very rewarding.
• 05:01- [Dr. Alperovich] It's a privilege, it's something we're very lucky that we get to do.
• 05:04You have these bonds with patients that last years
• 05:07and there's a gratefulness there
• 05:08and an appreciation there from them,
• 05:10and for me, there's an honor
• 05:11that I get to be a small part of
• 05:12something in their life that gets them
• 05:14to feeling good about themselves.
• 05:16- I don't think you can be a successful bariatric surgeon
• 05:19if you don't have empathy for your patients,
• 05:21and with that empathy comes a lot of reward
• 05:24when they've done well.
• 05:26Every time I see folks in the office,
• 05:28there is positive reinforcement
• 05:30that what I'm doing makes a difference.
• 05:33There may come a time
• 05:35when we find a neurotransmitter,
• 05:38a gut hormone or a non-invasive treatment.
• 05:41If that's the case,
• 05:42then I don't do bariatric surgery anymore,
• 05:44but that will be a happy time for me
• 05:46'cause it means
• 05:47we have cured the disease of obesity.