PubMed Health⌕ Search

Biomedical subjects

JK Smiertka

Publications and source records attributed to JK Smiertka.

5 recordsLinked to original sources
PubMed1996

Beyond Bariatric Surgery.Complications We Fail to Address.

As we now progress in the field of bariatric surgery, improving methods and fine tuning operative procedures, we witness many benefits. Fewer complications, shorter hospital stays, and more evidence of successful weight loss consistently appear in the statistics that have been accumulated through years of research. The information accumulated through years of research. The information provided, continues to verify that surgery is the most viable treatment for morbid obesity. There is minimal literature, however, that addresses the emotional issues faced by the patients who have undergone bariatric procedures. Postoperatively we may find at intervals of 3 months, 6 months, and even 1 or more years, a patient struggling to deal with their identity. The resolution or improvements of various medical anomalies, may seem insignificant as the patient now begins to focus on emotional and physical changes. Their bodies' new shape may create distressing personal concerns. Family members may also struggle with these psychological and physical changes. The surgery has forced the patient to deal with the loss of a love that is not easily replaced, the love of food. These, all too frequently, are the actual postoperative complications, co-morbidity changes, and weight loss, most importantly, we must also understand our responsibility to address the patients' emotional well-being. While indicating our concerns for the psychological as well as physiological recovery, the patient may then realize a healthier transition into life beyond bariatric surgery.

Journal Article↗
PubMed1995

Bariatric Surgery Postoperative Behavioral Change: The Importance of Ongoing Assessment and Teaching.

In bariatric surgery we modify, in varying degrees, the gastrointestinal system. We observe the patients clinically over the postoperative period of a few months or more. During this time our main concern is to monitor them physiologically, noting the decline in weight, change in body structure, and vast improvement in their comorbidities. Frequently the reaction of the patient may be somewhat surprising to us. One or 2 years past surgery they have forgotten about having had diabetes and hypertension, diseases for which they had received a barrage of medical treatment. It does not seem to matter anymore that at one time they wore a size 2X and now can wear size 14. Now we are forced to wonder what the expectation of the patient was. Our goal was to improve their physiological and psychological well-being, assuming they would go hand in hand with weight loss. If the patient does not recognize an improvement in their quality of life and continues to question their self-worth, then perhaps we should reassess our goals and our obligations. The principles of surgery and how it is or should be done is fairly clear. If we are to maintain standards of quality in this particular field of medicine, we must recognize our commitment to patients and make these principles just as clear. The commitment involves ongoing postoperative assessment and teaching, assessment of emotional well-being and lessons in dietary and physical activity, including exposure to and involvement in group support.

Journal Article↗
PubMed1994

The Challenge of Teaching Behavior Modification.

In March 1991 the National Institutes of Health claimed surgery as a viable means of treatment for clinically severe obesity once other conventional methods had failed. Also stated in the same report was that postoperative care, nutritional counseling and surveillance should continue for an indefinitely long period. Many surgeons are choosing regular office examinations and group behavior modification sessions for this surveillance. This educational process often poses insurmountable challenges for the professional who chooses to follow the patients postoperatively. As the doctor continues to monitor vital signs and systems, the group facilitator must monitor the patient's emotional ups and downs, signs of low self-esteem, and evidences of self-defeating behavior. Considering this, the ultimate challenge is that those who teach must understand what needs to be taught. The educational process could be divided into three areas, including lessons of the mind, the body, and the 'self.' The group leader will not always find the material for these lessons in books. Many will be developed through heartfelt experiences, but the most important resource for information will be the patient.

Journal Article↗
PubMed1994

Motivating the Bariatric Patient.

Bariatric surgeries can fail. Whether it be the fault of patient or the procedure, an evaluation of the reason for failure should be done. If the fault is with the procedure, there are revisions. If it is with the patient, how do we revise human behavior? A judgment must be made preoperatively if the patient will be an acceptable operative risk, and if the individual is an acceptable personality risk. Behavior modification, and a focus on positive factors of weight loss are what are believed to be characteristics for successful weight loss and long-term success. A multidisciplinary team should work together preoperatively and postoperatively to educate, encourage and support the bariatric patient so that he or she will be able to focus on motivation and compliance. The goal is to see that each individual will internally develop a sense of personal confidence and self-worth.

Journal Article↗