Definition of Paradigm Shift
"A time when the usual and accepted way of doing or thinking about something changes" ... Cambridge Dictionary
The following advice is from my good friend and Huron Valley-Sinai Hospital Nurse
Laura Kern...Thank you Laura!
Laura Kern, RN, BSN, CBN
Huron Valley-Sinai Hospital
Bariatric Nurse Navigator
Bariatric Nurse Navigator
... "I love my job as Bariatric Nurse Navigator for Huron Valley-Sinai Hospital. My primary role is to serve as a resource and to coordinate care for weight loss surgery (WLS) patients. I have the pleasure of coaching patients to a healthier self. I am proud to coordinate the bariatric program at HVSH. In addition to providing education and support to patients and their families, I am responsible for staff and community education, various quality initiatives and accreditation requirements. We have an integrated team of health professionals who provide excellent and compassionate care to a very unique and special bariatric population"... Laura Kern
Before surgery, how do you prepare a patient for the upcoming changes in their lives? Is that something you talk about? What advice do you give them?
Pre-operatively I offer patients assistance in getting through the extensive insurance requirement workup. I make every attempt to prepare them for what to expect during the pre-op workup stage, the day of surgery and while in the hospital and when they go home, as well as long-term lifestyle changes they will need to make to be successful. I stress that WLS is a tool, not a cure. I am available via phone, e-mail or in person as needed. Patients can contact me via phone when I am not in the office. I offer a pre-op class for them to attend with a significant other to help prepare them as they embark on their journey.
First and foremost, I assure them they there is no need to be embarrassed or ashamed and that they are not being judged "by the size of their belt," but by their mind, heart and contributions to society. WLS is not an easy decision and is not the easy way out. I applaud them for taking this important step and encourage them to make the necessary changes in their diet and exercise regime, as well as smoking cessation if necessary. I also make sure they know that I am available to coach them through the journey and encourage them to attend support group meetings (live or on-line) and to seek help. I make it clear they are not alone and that it helps to have the support of individuals who understand, as sometimes family and friends can sabotage their efforts and not truly get it. It is not easy to change lifelong habits and coping mechanisms.
How do you encourage those who are already on their journey?
I see patients in the pre-op holding area before they go in for their surgery and provide support and teaching to them and their families while they are in the hospital. Some patients need extra support or encouragement to just get out of bed and move following surgery or to get in their fluids and take deep breaths, but I try to make sure they all know that this is an expectation before they even come to the hospital. I round on patients and or call them on the phone everyday they are in the hospital and reinforce discharge teaching which is actually started in the pre-op phase. I call patients at home a day or two after they go home to make sure they are okay and answer any questions. They are encouraged to call me with any issues, physical or emotional.
Many have remorse just after surgery and need to know that they will feel better and will get through the inital phase. As they progress, I send out motivational e-mails on occasion and facilitate monthly post-op support group meetings here at Huron Valley Sinai Hospital (2nd Tuesday of the month in the Sinai Medical Office Building). These meetings are generally educational in nature, but there is always time to share what challenges they are facing and have the group and I provide feedback and support.
Their lives continue to change ... do you find that some patients at this point, do better with change..embracing life's challenges?
Of course. Many patients embrace change and do well, especially as they start to lose weight and their self esteem improves. Others struggle with changing their habits and accepting their new dietary constraints, adopting an exercise program and accepting their new bodies, as well as the new way others look at them. They have been discriminated against and judged by others for being overweight and reactions vary from sexual attention they are not used to receiving to being rejected by their partners or facing jealousy issues by their significant others.
Are there patients in your estimate ..who just don't do well with change? Can you give some examples? What advice do you give them to get them back on track?
There are those who just don't do well with change or are not willing to change! Some, but not all, WLS patients were overeaters or turned to food for comfort or to "hide" or "protect" themselves in the past which helped lead to their obesity. If the patients do not deal with the issues that led them to that coping mechanism, they may revert to old behaviors and or replace them with others, such as drinking alcohol.
There are many examples I can think of, for example a patient that blames the spouse for their eating behaviors and do not take ownership of what they choose to eat saying that their significant other is feeding them the wrong foods. Another who blames their employer for now allowing sufficient time to eat a healthy meal so feels she only has time for poor choices.
My advice is to let go... you cannot change others, but can change yourself.... Put yourself first... Make a commitment to yourself to take time and take care of yourself... Attend support groups... Journal... Keep a food diary... Find activities to replace eating... Walk, bike, run, play with your kids or grand kids - get active!... Start new traditions with your family and friends that involve healthier alternatives... Share your feelings and concerns with others who understand... Seek help!
Can you identify some of the major pitfalls for patients after WLS?
Immediately after WLS most patients are not really hungry and or cannot eat as much as they used to. This is a result of the stapling of the stomach, hormonal changes and changes in metabolism. This makes weight loss easy at first. But as time goes by, patients find themselves able to eat more food and more of the wrong foods without consequences. Sometimes life happens and patients are faced with stress and challenges that make them turn to old habits. It is normal to see some weight regain after a couple of years. Patients may start to beat themselves up, feel guilty or like a failure and become depressed adding to the cycle of overeating the wrong foods. That is why it is so important to adopt healthier lifestyle and eating habits during those first couple of years and to establish a support system!
What advice would you offer to all of your patients - when it comes to achieving life long success after weight loss?
My advice is to take advantage of this opportunity to start over and live a healthier life!
When all else fails..when is it time to seek professional help?
When a WLS patient is feeling depressed and out of control and unable to refocus their efforts, it is time to seek professional help. There is absolutely nothing wrong with that! Everyone has history that has been woven into their tapestry of life which sometimes needs to be faced and brought to the surface in order to deal with it, accept it and move on. Nobody can change the past, but everyone has the power to change their future.
No comments:
Post a Comment