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Weight Loss Surgery Requires Team Approach

By Mike Hudson

Tera Ciesla

Immature people often stare and make fun of overweight people.

These before and after photos demonstrate there is ample reason to lose weight for the morbidly obese.

"The earth is enjoyed by heroes"
-this is the unfailing truth.

Morbidly obese patients in need of bariatric surgery tend to have a lot of medical problems induced by their obesity and that makes them high risk, more difficult patients. So in order to maintain patient safety, at Niagara Falls Memorial Medical Center there  one person, Tera Ciesla, looks at each case individually and coordinates every aspect of patient care.

Ciesla, who is the bariatric coordinator at Memorial, says “frequently patients have to have many tests and consultations by different specialists to make them healthy enough before surgery to reduce their risks. It’s impossible for patients to coordinate on their own whether they need to see four or five different specialists or know which tests they need to go get.”

It is her job to walk patients through the process and figure out what they need to maintain safe outcomes.

“I deal with the insurance companies, I track our quality data, do our training and in-services for the nurses and staff in the hospital, and that sort of stuff,” she told the Niagara Falls Reporter. “The other role I play is the physician’s assistant. I am there to support the physicians medically so I see the patients in consultation, assist in surgery, make sure they have been prescribed the appropriate medications and then see them in follow-up as do the surgeons after their surgery is done.

“Some of the most common ones we coordinate for our patients are pulmonologists, doctors who specialize on the lung. Obesity carries a very high risk of sleep apnea and patients that have sleep apnea can be higher risk for anesthesia and before general surgery a complete sleep study is performed.

“We make sure they are treated for their sleep apnea and we normalize their oxygen and carbon dioxide levels before surgery. And we like to have their hearts examined by the cardiologist because their hearts are often strained from being obese over a long period of time.¬† We also perform endoscopies on most patients prior to surgery to look at the lining of the stomach and make sure there is no ulcer disease or reflux disease that would impair their healing after the surgery because if we can diagnose that before the surgery we can treat that and it improves their wound healing and makes a safer recovery for the patient.”

Diabetes is very common in the overweight Niagara Falls population, so Ciesla and her team work closely with endocrinologists as well as addressing the various psychiatric issues that come as a result of being obese. And there are a lot of psychiatric issues that come after their surgery as patients adjust to their new lifestyle and rapid weight loss.

A lot of it is good, but all change is stressful, so Ciesla works closely with NFMMC’s behavioral health and psychiatric departments to make sure the patients are well adjusted.

Dr. Bala Thatigotla and his team would like the people to know that a patient information seminar is held on the third Monday of every month at 5:30 p.m. The team is also in the process of setting up patient information seminars offsite to make it more convenient for patients to get the information.

The team will be looking for locations to be holding patient information seminars in other parts of the county: Lockport, North Tonawanda, Youngstown, Lewiston and Wheatfield.

Dr. Bala said there is a tremendous unmet demand, unmet need for this type of surgery, and they are doing everything they can to make this more accessible to people so they can learn and know more about bariatrics to see if it’s appropriate for them.




Niagara Falls Reporter - Publisher Frank Parlato Jr. www.niagarafallsreporter.com

May 07, 2013