SideBySide Spring 2014 complete issue

SPRING • 2014
Weight Loss Surgery
Hope for Diabetics
Advances in Transplant
Help Save Lives
Protect Yourself
from Colon Cancer
Community Classes
and Support Groups
SUTTER WEST BAY
HOSPITALS
BOARD OF DIRECTORS
2014
OFFICERS
A colleague and I started talking about gifts and giving a few weeks ago. I am not
sure how the subject came up – perhaps it was that the holiday season, with its
tradition of gift giving, had just ended.
She told me: “I really believe giving is inherent in every one of us, something we are
hard-wired to do. When I was young I resisted being a giver, wrongly thinking that it
only had to do with consumerism and overconsumption. But I eventually realized that
there are many ways to give that don’t involve buying things.”
My colleague is right – oftentimes the most precious gift we can give, or receive,
is something you won’t ever find in a store window.
If you could give the gift of independence, health and hope, would you? That is what
happens all the time with the CPMC team that has perfected the art and science of
bariatric surgery – a procedure to assist people in losing dangerous weight.
In this issue on page 14, you will meet Abe Lee and Marcia Whitaker, who learned
from Gregg Jossart, M.D., director of the CPMC bariatric surgery team, that losing
crippling weight brings advantages far beyond improving one’s appearance. It can
mean avoiding the serious consequences of being overweight – diabetes, high blood
pressure, risk of blindness and heart disease.
Michael J. Cohill, Regional President
Anthony G. Wagner, Chair
Robert A. Rosenfeld, Vice Chair
Theodore Deikel, Chair, Finance and Planning
John B. Gates, CPA,
Regional Chief Financial Officer
Michael Duncheon, Secretary
MEMBERS
William L. Brunetti
Michael J. Cohill
Dorothy Coleman-Riese, M.D.
Susan H. Day, M.D.
Theodore Deikel
Thomas J. Dietz, Ph.D.
Roy Eisenhardt
Katherine T. Hsiao, M.D.
Peter Jacobi
Frederick Johnson, M.D.
Steven Katznelson, M.D.
Sarah Krevans
Steven E. Levenberg, D.O.
Thomas E. Lincoln
Alastair A. Mactaggart
Timothy Murphy, M.D.
Dennis J. O’Connell
Steven H. Oliver
Robert A. Rosenfeld
Leo C.H. Soong
Michael N. Valan, M.D.
Anthony G. Wagner
Richard C. Watts
Deborah D. Wyatt, M.D.
Both Abe and Marcia rate their surgeries as a total success. Abe, who lived with
MARKETING DEPARTMENT
diabetes for years, says, “The day after my surgery my blood sugar had already
Jim Macksood, Director of Marketing
Christina Szeto, Editor
Lisa Oliver, Graphic Designer
dropped to a normal range without insulin. It was like a switch turned on.”
The people we write about in this issue and the outcomes they have experienced are
an important reminder – modern medicine cannot solve every disease or condition,
but there are enough triumphs for us to say, with all honesty, that today’s “medical
miracles” are truly a gift, in all senses of the word.
Warren Browner, MD, MPH
Chief Executive Officer, CPMC
CONTRIBUTORS
Kermit Cantwell, Esther Chapman,
Lily Tung Crystal , Madeleine Kahn,
Laura Miyashita, Shaun Ralston,
Rebecca Southwick, Mary Strebig,
Penny Cleary
PHOTOGRAPHY
Ed Aiona, Saul Bromberger & Sandra Hoover Photography, Seth Joel Photography, Suzette Tay Lee, Alain McLaughlin, Bob Minkin, Bill Posner, CPMC Media Services
COPY EDITOR
John Maybury
Copyright © 2014 Sutter Health WBR.
All rights reserved.
14
pg
pg
5
pg
8
11
pg
Contents
SIDE BY SIDE MAGAZINE | S P R I N G 2 0 1 4 | C A L I F O R N I A PA C I F I C M E D I C A L C E N T E R
4 CPMC Foundation News 5 Advances in Transplant
Help Save Lives
8 Protect Yourself from
Colon Cancer
*Cancer Screening Guide included*
11 Bioethics at the
Bedside: Tackling Tough
Ethical Questions
14 Weight Loss Surgery
Gives Hope to Diabetes
Patients
17 Community Classes
and Groups
FoundationNEWS
Maurice Kanbar
“Thank you to our philanthropic
partners who help make
state-of-the-art care available to
thousands of patients each year.”
Suzanne Wright and
Wensley El-Hefni
CPMC CARDIOLOGY RECEIVES
$5 MILLION GIFT
Local inventor Maurice Kanbar made a $5
million commitment to the Kanbar Cardiac
Center at CPMC in 2013. This is his second
$5 million gift to CPMC cardiology, which
provides a wide range of state-of-theart diagnostic and therapeutic cardiac
services including heart surgery, heart
transplantation, interventional cardiology,
electrophysiology and much more.
The center is considered among the best
heart and cardiovascular services in the
country. In fact, it is one of just six hospitals
in California to have received a platinum
achievement award in 2012 from the
American College of Cardiology Foundation
for consistently following heart attack
patient treatment guidelines. Mr. Kanbar’s
generous pledge will help CPMC continue
to provide this extraordinary care to all
CPMC cardiology patients.
4
EL-HEFNI FAMILY
CONTINUES LEGACY
Building upon past gifts totaling nearly
$2 million, the El-Hefni family and the
Massachusetts-based El-Hefni Technical
Training Foundation have made an
additional commitment of $3.5 million
to the El-Hefni Liver Biorepository and
Liver Disease Research and Education
at CPMC. The biorepository, guided by
Adil Ed Wakil, M.D., associate chief of
Hepatology, and Stewart Cooper, M.D.,
research director, is one of only a few
dedicated liver biorepositories in the United
States. Physicians and scientists around
the nation and the world use the human
tissue and blood samples maintained by the
biorepository to research, understand and
prevent liver disease.
Paul May
REMEMBERING PAUL MAY
CPMC lost a true friend and philanthropic
partner when Paul S. May passed away late
last year. Together with Frank Stein, Paul
generously helped improve care for CPMC
patients by investing in the Paul S. May
and Frank Stein Interventional Endoscopy
Center, the Frank Stein and Paul S. May
Low Vision Center, and CPMC’s St. Luke’s
Cardiovascular Center.
“The words ‘generous’ and ‘compassionate’
only begin to describe Paul,” said Warren
Browner, M.D., CEO of CPMC. “He had a
depth and sincerity of feeling, along with a
sense of humor that made him a one-of-a­
kind person and philanthropist. I will miss
him deeply.”
Paul and Frank’s gift to the Interventional
Endoscopy Center that bears their names
helped launch a facility that has quickly
gained a national reputation for removing
gastrointestinal polyps, cancers and stones.
“They were instrumental in making this
world-class service at CPMC a reality,”
says Kenneth Binmoeller, M.D., the center’s
director. “Thanks to them, every year
thousands of patients receive state-of-the­
art care for complex digestive diseases.”
Advances in Transplant Help Save Lives
By Lily Tung Crystal
More than 120,000 people need organ transplants in the United States. Of those, nearly 20 die each day
from the lack of available organs. And that number of those needing organ transplants continues to rise
due to skyrocketing rates of diseases like diabetes and high blood pressure.
“There is a growing demand for organ transplant, but there is a limited supply of
organs,” says William Bry, M.D., surgical director of Sutter Health CPMC’s Kidney
Transplant Program. That’s why transplant centers such as CPMC are using new
approaches—such as kidney paired donation and organ perfusion—that help
maximize the organs available for transplant.
THE GIFT OF LIFE
Taiwan Walker of Richmond, 42, faced the grim future of a long wait for kidney
transplant. After nearly 20 years with hypertension, Taiwan’s kidneys gave out
in 2010, forcing him to go on dialysis. His uncertain health outlook and the
seemingly never-ending time he spent hooked up to a machine devastated him
physically and mentally. “I was feeling horrible, tired and trapped,” Taiwan says.
“It was like a slow death.”
Taiwan’s aunt, 58-year-old DeWanda Stewart-Joseph, couldn’t stand
watching her nephew suffer and slowly fade away, so she underwent a living
donor screening at CPMC’s renowned Barry S. Levin, M.D. Department of
Transplantation. At the forefront of transplant advances, CPMC has performed
more than 6,000 kidney, pancreas, heart and liver transplants, with 275 surgeries
in the past year alone.
When tests showed DeWanda was a match, she offered her nephew her kidney.
“I’d do anything for him,” she says. “As much as he needed to live, I needed him
to live.”
At first Taiwan refused. “I didn’t want anything to happen to her,” he recalls. But
doctors assured both of them that living donation posed few risks. Finally this
past November, the pair underwent transplant surgery.
RECOVERY AND REBIRTH
“I’m feeling like a brand-new person,” Taiwan says. “The dark cloud has lifted
and I can live my life with new hope.” Taiwan is now making plans for his future,
hoping that his love of cooking will lead to him owning his own restaurant. “He
has a new shine about him,” adds DeWanda.
After her six-week recovery, DeWanda regained her energy and returned to her
job as a community advocate and case manager, working with families and
children. “People say, ‘You gave the gift of life; you’re a hero,’” she muses, “but
I’m just looking forward to spending time with my nephew and watching him
flourish.”
Even though Taiwan was lucky enough to have a compatible donor, at least
one-third of individuals with living donors are incompatible with them. That’s
why CPMC is at the forefront of kidney paired donation—a process in which
kidneys are “exchanged” between pairs, making multiple, compatible living donor
transplants possible. In 2011, the hospital made history as the first California
transplant program to perform five paired donor kidney transplants in one day.
CREATING HOPE OUT OF TRAGEDY
For individuals awaiting a liver or heart transplant, they rely on the nationwide
system of organ allocation from deceased donors.
"I'm feeling like a brand-new
person," says Taiwan, of his
kidney transplant.
6
Napa winemaker Spencer Hoopes, a previously healthy 66-year-old skier,
golfer, and fisherman, found himself in desperate need of a liver transplant in
March 2013. Doubled over in abdominal pain from an aneurysm on his hepatic
artery, Spencer was transported to the hospital because his artery had started
unraveling into his liver, destroying it. “I was losing eight to 10 units of blood
a day,” recalls Spencer. “If the artery had burst, I would’ve died.” Spencer’s
condition was one of only 22 such cases
in recorded history, and doctors didn’t have
many options. He needed a transplant
immediately.
"I'd do anything for Taiwan,"
says DeWanda, of her decision
to donate her kidney.
Fortunately for Spencer, the California
Transplant Donor Network (CTDN) works
with local hospitals to provide information on
organ donation to families whose loved ones
have died. One such family came forward,
and Spencer received his liver transplant at
CPMC on May 2, 2013. The organ started
working immediately, and within three
months, Spencer returned to his active
lifestyle. “It was a miracle—an opportunity
to live life, do things better, and be more
helpful to others,” says Spencer. “I’m
extremely grateful, but it’s bittersweet. I can
only imagine the sadness and tragedy of my
donor’s family. Yet they still understood that
their loved one’s organs could help another
person live. It’s an unbelievable gift.”
"As much as he needed to
live, I needed him to live."
TEAMWORK COMBINED WITH
EXPERTISE
Spencer, Taiwan and DeWanda are also
grateful that they were in the hands of
California Pacific’s transplant team, a
dedicated group of specialty doctors,
nurses and support staff. “My doctors
were not only detailed and proficient,” says
Spencer, “but they came by my room every
day and showed incredible enthusiasm for
my progress. I wouldn’t be here today if it
weren’t for them.”
“Everyone was so attentive,” adds DeWanda.
“I didn’t want to go home—that’s how
excellent the service was!” “The doctors
showed us a lot of love,” adds Taiwan. “After
our surgery, the entire team had tears in their
eyes—I’d never seen anything like it.”
That emotion comes because doctors and
nurses know they’re witnessing something
uniquely special when one person gives life
to another. Organ donation is a rare gift, but
it doesn’t have to be. “If people just look
around,” says Bry, “they’ll find that someone
they know is in need of a transplant. This is
not a theoretical issue; it’s a real one.”
Take Action: Visit
DonateLifeCalifornia.org and register to
be an organ donor. ✤
FIVE FACTS ABOUT ORGAN DONATION
April marks Organ Donation Awareness month, a good time
to learn the facts about organ donation:
1
1. One person can
save eight lives and
enhance 50 others
through organ and
tissue donation.
2. Anyone can become a
potential organ donor
regardless of age,
ethnicity or medical
history.
2
3. Organs are allocated
according to medical
need, blood and
tissue type, height
and weight. Celebrity
status and wealth are
not considered.
3
4. You can sign up
to be an organ
donor by checking
“yes” when applying
for your driver
4
license or online at
DonateLifeCalifornia.
org
5. More than 120,000
Americans are
currently waiting for
an organ transplant. It
is their only remaining
medical option.
5
Source: DonateLifeCalifornia.org
7
Protect
Nurse Navigator Suzanne Much, R.N., helps patients
diagnosed with colorectal cancer (at Sutter Health
CPMC) before, during, and after surgery.
8
Yourself
From Colon Cancer
SCREENING SAVES THE LIFE OF SAN FRANCISCO MOTHER
By Esther Chapman
March marks Colorectal Cancer Month, which may not seem worth celebrating until you consider
that reliable screening methods and surgical techniques have made colorectal cancer one of
the most preventable cancers. Now, two-thirds of individuals over age 50 have had a colorectal
screening, which is the best way to prevent deadly late-stage cancer. Despite this progress,
millions still do not get screened for colorectal cancer and it remains the second-deadliest cancer
for both men and women.
“With more regular screening, earlier diagnosis and removal
of precancerous polyps, the death rate for colorectal cancer
has been decreasing about 2 percent per year,” says Michael
Abel, M.D., a colorectal surgeon and medical director of the
Colorectal Cancer Center of Excellence at Sutter Health’s
CPMC. “Patients are better informed and are more willing to
undergo screening examinations,” he explains.
Recognizing the Warning Signs
Lori Cadigan considers herself one of the lucky ones who fall
into those improving statistics. The 47-year-old San Francisco
police officer and mother of two was healthy, fit and active
three years ago when she first saw her doctor about persistent
hemorrhoids and occasional blood in her stool. After nine
months of treatment without progress, she asked her doctor if
she could get a colonoscopy, a test used to check the inside
of the entire colon and rectum.
“I don’t know what made me ask for that test, because I
didn’t have any of the typical risk factors. I was under 50 and
had no family history of colorectal cancer. I wasn’t overweight.
And I don’t smoke or drink,” she says. “But nothing else
seemed to be working. And my colleague’s wife had recently
been diagnosed with colon cancer, so maybe that was on my
mind.”
In a colonoscopy, the physician inserts a thin, flexible, lighted
tube into the colon to look for polyps, which are small growths
that over time can become cancer. The colonoscopy is one
of three screening tests used to detect colorectal cancer.
The others are the fecal occult blood test, which uses a stool
sample; and sigmoidoscopy, in which the doctor uses a lighted
tube internally to examine the rectum and half of the colon.
“All three are very reliable, but many patients choose
colonoscopy because it’s more complete, more accurate and
you only do it every 10 years, typically starting at age 50 unless
you have a family history of colorectal cancer,” explains Robert
Faust, M.D., a gastroenterologist with Sutter Pacific Medical
Foundation in Santa Rosa.
Colonoscopy Uncovers Cancer
For Lori, the test proved fortuitous. Her colonoscopy showed
a polyp in her colon, and a biopsy confirmed that Lori had
colon cancer. “I was thinking colitis maybe, but not cancer!”
says Lori, who felt blindsided by the news. Yet when she met
with Dr. Abel to discuss surgery, her panic subsided a bit. “Dr.
Abel took a lot of time to discuss the procedure in depth and
called me personally to answer questions, so I felt like I was
in good hands,” she says. In the meantime, the staff at the
Colorectal Cancer Center of Excellence handled every detail of
her surgery preparation.
“There was no effort on my part at all. Once you’re
told you have cancer, you can’t think, you can’t
function. Everything is a blur, and having a good
support group and medical staff to tell you what’s
next is great,” she says.
Nurse Navigator Provides Caring Support
The Colorectal Cancer Center of Excellence was founded four
years ago to provide comprehensive and results-focused care
to patients like Lori. The center offers patients unlimited access
9
to a Colorectal Cancer Nurse Navigator, who helps before and
after surgery to schedule appointments, make referrals, and
navigate any hurdles patients may face.
The center also focuses heavily on results-oriented care, with
an emphasis on quality improvement. A Tumor Board meets
monthly to discuss each patient’s care and determine the best
course of action. Quality assessments are conducted quarterly,
with findings reported to the Quality Improvement committee
so that appropriate changes can be made. “Because of this,
our recovery time is quick and patient outcomes are excellent,”
says Dr. Abel
Surgery Proves Life-Saving
Lori’s surgery was done laparoscopically, using only small
incisions in the abdomen. Dr. Abel removed the tumor and six
inches on either side of the colon, then reconnected the two
sides. The entire procedure took two and a half hours.
“When I woke from surgery, I felt sore, like someone punched
me in the gut, but was well enough to stand and walk that
same day,” says Lori. The rest of her recovery went swiftly. She
began eating soft foods the following day, and went home four
days after surgery. Six weeks after her colon surgery, she was
back at work.
Today, Lori undergoes regular blood work and screenings,
but otherwise feels back to normal – though with a new
perspective on life and health. “If I didn’t get that colonoscopy,
I probably wouldn’t be here today,” she says. “Every day I wake
up and I’m so thankful. For the amount of time it takes to do a
colonoscopy—30 minutes in and out—it’s so worth it.” ✤
Take Action:
Ask your primary care doctor for more information or for a
referral to get screened for colorectal cancer. To find a primary
doctor, call 1-888-637-2762.
COLONOSCOPY
Used to detect colorectal cancer, a colonoscopy uses
a thing, flexible lighted tube inserted into the colon.
The doctor moves the tube to look for polyps – small
growths that over time can become cancer.
© 2014. Nucleus MedicalMedia. All rights reserved. www.nucleusinc.com
10
Bioethics at the Bedside
Tackling Tough Ethical Questions
By Madeleine Kahn
Melissa Sitter at home in St. Helena two
years after her husband’s passing from
melanoma. “The bioethicists in the
Program in Medicine & Human Values
helped Tom die a death of great dignity,
in my arms, just as he wished.”
“I have given you the power to make
these decisions. Use it.” These were
Melissa Sitter’s instructions from her
husband when he was hospitalized
with end-stage melanoma.
“I felt that Tom had given me such a terrifying
responsibility,” says Mrs. Sitter now, more than
two years after his death. “How do you know
which is the right moment? You’re grieving,
you’re overwhelmed, and there is so much
medical information to consider. Thank goodness
one of the nurses mentioned the possibility of an
ethics consultation.”
“It’s a very profound job they have
of lovingly guiding people towards
dying well.” —Melissa Sitter
The Program in Medicine & Human Values
provides clinical ethics consultations at Sutter
Health’s hospitals in Santa Rosa, Lakeside,
Novato, and at California Pacific Medical Center
in San Francisco. The program is unusual in
that the bioethicists speak directly to the patient
if possible, to the family, and to the doctors
and nurses involved in the patient's care.The
bioethicists’ goal is to help providers and family
members make the health care decisions that the
patient would make if he or she were capable of
doing so.
It is a sign of medicine’s success that the need
for bioethics consultations is growing: We are
all living longer, even with serious diseases such
as cancer. And for stroke patients or those with
other neurological disorders, it is vital to have
a process that will help determine the ethical
appropriateness of medical treatments to be
provided to the patient. Finally, each patient has
different health care goals and a unique cultural
context for determining those goals. An ethics
consultation takes into account the patient's
wishes, the physicians’ and nurses’ professional
values, and the accepted moral standards of the
community.
“We support the treatment of each
patient with respect, dignity, and the
appropriate care.”
– William Andereck, M.D., co-founder of the Program in
Medicine & Human Values
12
Thomas Sitter was no longer able to speak for himself, but he’d
made his wishes very clear to his wife Melissa. William Andereck,
M.D., and Ruchika Mishra, Ph.D., from the program directed a
process that allowed each member of the care team, plus the
Sitters’ children, to recognize that Tom had passed the point
of heroic medical measures. “It’s a very profound job they have
of lovingly guiding people towards dying well,” says Mrs. Sitter.
“Because of them, my husband died a death of great dignity,
in my arms, just as he wished.”
Mrs. Sitter lives in St. Helena, and is particularly pleased that
the program is expanding its reach to her local hospitals.
“Access to this program could be, possibly, the best thing in
our last moments of life,” she says. Recent cases at several
Sutter West Bay hospitals have providers echoing that sentiment.
Siri Nelson, chief administrative officer at Sutter Lakeside, says,
“The bioethics team at CPMC consults with us frequently and
helps us wade through sometimes very muddy water.” And
Deborah Levin, a social worker at Novato Community Hospital,
agrees: “The CPMC bioethicist and the ethics committee at
Novato provided great support and a framework for us to think
through an ethical dilemma.” The program has recently hired a
second bioethicist, David Campbell, Ph.D., to staff Sutter Health’s
West Bay hospitals.
“After our ethics consultation the family
said, ‘Wow, you really care for our dad as
much as we do; thank you.’”
– Andrea Nofi, R.N., ICU Nurse, Sutter Medical Center of Santa Rosa
The program’s work with individual patients is grounded in
research and scholarship. Through publications and seminars,
the program has had a hand in educating an entire generation of
bioethicists, and continues to be a leader in establishing the best
practices in new areas, such as those arising from the rapidly
developing field of neuroethics. Ultimately, all of this work comes
back to the same goal: to provide individualized advice in ethically
challenging situations, and to help the entire care team treat each
patient with respect, dignity and the appropriate care. ✤
William Andereck,
Bioethicist
M.D., co-founder
Ruchika Mishra,
of the Program in
Ph.D. counsels a
Medicine & Human
family member in
Values (left) with
making health care
Bioethicist Ruchika
decisions on behalf
Mishra, Ph.D.
of a loved one.
The care provided by the Program in Medicine & Human Values is not reimbursed by insurance. The program
has been sustained by our philanthropic partners ever since the visionary gift that brought the program into
being. For more information about how your charitable investment can make a difference to your local
Sutter Health hospital and possibly qualify for a 2014 matching grant from Sutter Health, please contact us.
San Francisco
and Bay Area
CPMC Foundation
415-600-4400
cpmc.org/giving
Marin County
Novato Community
Hospital
Fund Development Office
415-209-1828
novatocommunity.org/
foundation
Sonoma County
Sutter Medical Center of
Santa Rosa and Sutter Pacific
Medical Foundation
Fund Development Office
Lake County
Sutter Lakeside
Hospital Foundation
707-262-5121
sutterlakeside.org/giving
707-576-4009
suttersantarosa.org/philanthropy
13
Abe Lee holds up a picture of he and his wife
Suzette before his successful sleeve gastrectomy a weight loss surgery offering new hope to patients.
14
Weight Loss Surgery Gives
Hope to Diabetes Patients
By Lily Tung Chrystal
Forty-year-old Abe Lee of San Francisco was
quickly running out of options. For 15 years, he
had had Type 2 diabetes, weighed 265 pounds,
and was in poor health. No matter how much
dieting or exercise he did, he couldn’t get his
weight down. The insulin he was taking only
made him gain. To make matters worse, his
body was growing more insulin-resistant, and he
needed increasingly higher doses.
At the same time, Marcia Whitaker, 62, grieved her husband’s early
death from brain cancer, and started getting worried about her own
mortality. She had a litany of health problems—sleep apnea, high
cholesterol, and high blood pressure—and was at risk for developing
diabetes. At her heaviest, the 5’3” Union City resident weighed 250
pounds. She tried everything to keep her weight down, including an
all-liquid diet, working out, and getting a personal trainer, but nothing
worked. “I couldn’t climb a set of stairs without getting winded,” she
recalls. “My husband died at the age of 63, and I didn’t want to have
any condition that would take me off this earth early.”
Hope for a Cure
Abe and Marcia were starting to feel hopeless until they met with
Gregg Jossart, M.D., director of bariatric surgery at California Pacific
Medical Center, and his multidisciplinary team of doctors, dieticians
and nurses.
Initially, weight loss surgery seemed extreme, but under the caring
guidance of Dr. Jossart, they soon realized that it could possibly cure
them of their medical conditions. Many patients who undergo the
surgery are happy to overcome their metabolic issues. “Dr. Jossart
made the extra effort to get to know me and my wife and explain how
the surgery could help me,” says Abe. “It wasn’t about losing weight
for my appearance. My goal was to address my diabetes. If I could get
rid of my excess weight, my natural insulin would work better.”
From Stomach to Sleeve
Although Dr. Jossart offers several types of bariatric surgery, he
recommended sleeve gastrectomy for both Abe and Marcia. In
this procedure, surgeons restrict food intake by removing part of
the stomach and leave a narrow pouch, or sleeve. Other types of
surgery include lap-band surgery, in which doctors place a silicone
band around the stomach, and gastric bypass and duodenal switch
surgeries, which require both stomach restriction and rerouting of
the small intestine.
Dr. Jossart prefers the sleeve gastrectomy for most cases. “The
stomach that’s left behind is more natural. It doesn’t have the
problems of a foreign body like the lap band, which can create
blockages,” he explains. “And there’s no intestinal bypass, which can
15
cause complications like bloating and diarrhea. Sleeve gastrectomy
also gives patients a better quality of life since they can eat a greater
variety of food.”
After surgery, Abe was back at his software design job within five
days. And in less than a year, he lost 100 pounds – from clothing
size XXL to a small. Before surgery, he didn't go outside often, he
now works out an hour and a half every day and takes long walks
with his wife. Abe says, “Imagine you had to wear a 100-pound
backpack all your life and then took it off. My knees don’t hurt as
much; I can walk faster; and I have a lot more energy.”
Team Commitment
Sleeve gastrectomy surgery takes only one to two hours, and
patients leave the hospital after just one overnight stay. The
lifestyle change requires a lifetime commitment to healthy eating.
Dr. Jossart’s team of doctors, dieticians and nurses meets with
patients for years following surgery and organizes monthly group
meetings to help them stay on track.
But none of that compares to what happened to Abe’s diabetes,
which all but disappeared. “The day after surgery my blood sugar
had already dropped to a normal range without insulin,” Abe
marvels. “It was like a switch turned on, and it never went up again.
I went from having an insulin pump to taking no medicine.”
“It’s great because you can share with people who have been
through the same thing,” says Marcia. “Dr. Jossart is incredibly
informative, empathetic and empowering, and his staff really got to
know me and gave me the tools I needed to succeed.” “The staff
were excited and passionate about my progress,” Abe agrees. “They
were 100 percent with me.”
Marcia also stopped taking her medications the day after surgery
and no longer needs her sleep apnea machine. “It’s a whole new
me,” she beams. “My children are amazed, and they’re happy that
I’ll be around longer for my grandkids. CPMC's bariatric surgery
team saved my life.” ✤
One Year and 100 Pounds Later
It’s been just over a year since Marcia and Abe had their surgeries.
Marcia has dropped nearly 80 pounds, now weighs 140, and went
from a size 24 to a size 8. She can climb stairs without any problems
and walks 25 miles a week. “I sometimes still think of myself as
someone with weight problems, but when I look in the mirror, I
realize that I’m not that person anymore,” she muses. “I have friends
who haven’t seen me for a year who literally stand next to me and
don’t recognize me.”
Sutter Health offers free bariatric surgery seminars and
physician consults in San Francisco, Marin and Sonoma
counties. Patients can sign up to determine eligibility and
find the best treatment for their specific needs at the
following websites:
San Francisco and
Marin Counties
sutterpacific.org/bariatrics
Sonoma County
suttersantarosa.org/bariatrics
Options for Weight Loss Surgery
Gastric Sleeve
• Average excess weight loss: 70 - 90%
• Restricts food intake & decreases amount of food used
• Second most common bariatric procedure in the U.S.1
• Emerging as most common procedure due to positive
safety and outcomes.
Ba
r ic
st
c
ri
Ga
st
Average excess weight loss: 40%
Decreases food intake
Reversible surgery
Third most common bariatric procedure in the U.S. 1
Least invasive, but some device-related problems can occur
Ga
•
•
•
•
•
nd
Gastric Band
s le
ev e
Gastric Bypass
SOURCES:
16
85.4%
78.5%
G as t ric
By
Bariatric Surgery Candidates
Outcomes2
After bariatrics surgery,
Abe's portions are a
fraction of what he ate
before (in foreground).
ss
Average excess weight loss: 70 - 90%
Restricts food intake and reroutes food
Reversible surgery
Most common bariatric procedure
pa
•
•
•
•
• BMI _> 35 with diabetes, 3
sleep apnea, high blood
pressure or heart disease
70%
85.7%
4
• BMI _> 40 if the above
medical conditions do
not exist
1. "Changes in the Makeup of Bariatric Surgery: A National Increase in Use of Laparoscopic Sleeve Gastrectomy" Journal of the
American College of Surgeons. Feb 2013 1013; 216(2): 252-257.
2. Henry Buchwald, MD, PhD; Yoav Avidor, MD; Eugene Braunwald, MD; Michael D. Jensen, MD; Walter Pories, MD; Kyle
Fahrbach, PhD; Karen Schoelles, MD. “Bariatric Surgery: A Systematic Review and Meta-analysis.” JAMA.
2004;292(14):1724-1737.
3. “New Evidence Prompts Update to Metabolic and Bariatric Surgery Clinical Guidelines.” American Society for Metabolic &
Bariatric Surgery. (2013). http://www.asmbs.org.
4. Weight-control Information Network, National Institute of Diabetes and Digestive and Kidney Diseases, http://win.nikkd.nih.gov/publications/gastric.htm
Community Classes
and Groups
California Pacific Medical Center offers a wide variety
of classes, events and support groups promoting a
healthy lifestyle. See the reference key on the next page
for contact information and locations (unless otherwise
noted). Visit cpmc.org/classes for a full listing.
Cancer
Cancer Caregiver Support
Group (CAN)
4th Thursdays, 4–5 p.m.
Call 415-600-3977 for more
information.
Colorectal Cancer (CHRC)
From an expert medical
oncologist, learn signs and
symptoms, risk factors,
prevention, and latest treatments
for colon cancer.
Wednesday, April 2, 5:30–7 p.m.
2333 Buchanan Street, Enright
Room.
Look Good…Feel Better: For
Women with Cancer (WHRC)
Receive cosmetics and wigs.
Call 415-600-0500 for dates
and times. Free.
Lymphedema Education,
Exercise & Prevention
Group (CAN)
3rd Wednesdays, 5:30-7p.m.
Call 415-600-3073 for more
information.
Liver Cancer
Support Group (CAN)
2nd Tuesdays, 2–3:30 p.m.
Free.
Call 415-600-1209 for more
information.
Melanoma Support Group
(CAN)
3rd Thursdays, 2–3:30 p.m.
Call 415-600-3977 for more
information.
Ovarian & Reproductive
Cancer Recovery Program
(WHRC)
Call 415-600-0500 for dates
and times.
General Health
Facials (WHRC)
75 min. $85; 90 min. $100.
Health Consultations
(WHRC)
Discuss menopause,
osteoporosis, preparing for
hysterectomy, mental health
assessment and referral and/
or nutrition. $60/hour.
Long-Term Care
Insurance (CHRC)
This seminar will explain what
long-term care is and costs.
April 9, 5–6:30 p.m., 2333
Buchanan St., Enright Room
Mind & Body Wellness
Healing Harp (IHH)
Free intros: Monday, April 14,
10-11:15 a.m. and Thursday,
April 17, 5:45-7:00p.m.
8 weeks: Mondays, starting
April 21, 10-11:15 a.m. and
Thursdays, starting April 24,
5:45-7:00 p.m. $325
(additional $75 for materials).
Diabetes
CALIFORNIA CAMPUS (DIAB):
• Adult Diabetes Education
(physician referral needed)
415-600-0506
• Type 1 and Type 2
- Individual and group
sessions
- Basic education
- Advanced education
• Carbohydrate counting
• Insulin pumps
• Continuous glucose
monitors
• Prediabetes-diabetes/
preventing diabetes
Adult Support Groups
• Type 2—Living with
Diabetes: 11 a.m.-12:30
p.m., Call 415-600-0506
for dates.
• Type 1—Insulin Pump
Group: 6-7:30 p.m.,
Call 415-600-0506 for dates.
Diabetes and Pregnancy
Program (Sweet Success)
Call 415-600-6388 for
more information.
Pediatric Diabetes Education
Program
Call 415-600-0750 for
more information.
S T. L U K E ’ S C A M P U S ( D I A B * ) :
Managing Vision Loss
(CHRC)
This lecture will explore ways
in which individuals who
experience vision loss and are
visually impaired can remain
independent. Thursday, April
17, 4 – 5:30 p.m.
2333 Buchanan Street,
Enright Room.
• Diabetes Adult Education
- Individual appointments
- Continuous glucose
monitoring
- Pregnancy and Diabetes
(Sweet Success)
- Insulin Pump Initiation
and Support
By appointment, M.D. referral
required. Call 415-641-6826 for
more information.
• Move to Improve,
Exercise for People with
or Who are At Risk for
Diabetes
Tuesdays, 11 a.m.–12 p.m.,
Bayview YMCA,
1601 Lane St., SF
Thursdays, 11 a.m.–12 p.m.,
St. Luke’s Campus
3555 Cesar Chavez St.
415-641-6682
Massage Therapy for
Women and Men (WHRC)
30 min. $40; 60 min. $70;
90 min. $90.
17
Nutrition and Weight
Senior Health
Essential Nutrients and Supplements (CHRC)
This lecture will identify essential nutrients, how to meet nutritional
requirements, and suggest ways to navigate the supplement market.
Thursday, April 24, 5 – 6:30 p.m.
2333 Buchanan Street, Enright Room
Arthritis Exercise Program
for Women (WHRC)
Call 415-600-0500 for dates
and times. Free.
• What to Expect: Caring for
Someone with Memory Loss
Call 415-600-5555 for dates
and times.
Fit for Life (SWC)
Mondays, 10:30–11:15 a.m.
Tuesdays, 2:30–3:15 p.m.
Thursdays, 10:45–11:30 a.m.
Yoga for Seniors (IHH)
New students – 3 classes for
$20.
FoodSENSE (WHRC)
10-week nutritional education program for women. Mondays,
6:30-8 p.m. starting in May. $300.
Physical Fitness and Mobility
Pilates Mat Classes (SWC)
Mondays, 9–10 a.m. & 6-7
p.m.; Wednesdays, 6–7 p.m.;
Fridays, 10–11 a.m.
Total Body Fitness (SWC)
Level I: Tuesdays 10–11a.m.,
Thursdays, 3–4 p.m.
Levels I & II:, Saturdays,
10–11 a.m.
Feldenkrais® (IHH)
Free intros: Thursday, April 10,
7-8:15 p.m. and Monday April
14, 2-3:15 p.m.
10 weeks: Thursdays, starting
April 17, 7-8:15 p.m. and Mondays, starting April 21, 2-3:15
p.m. $150.
Memory Loss (BHC)
• Creating a Positive Home
Environment
• Compassionate
Communication & Challenging
Behaviors
• Healthy Body, Healthy Brain:
Alzheimer’s Education Class
CAN = Bryan Hemming
Cancer Care Center offers
patients a variety of helpful and
compassionate care options in a
caring environment.
415-600-3081 | 2351 Clay St.
1st Floor | cpmc.org/cancer
Newborn Connections (NBC)
• Big Brother, Big Sister
Sibling Celebration
• Breastfeeding
• Childbirth Preparation
• Childbirth Preparation
Express
• For Expectant Fathers Only
• Maternity Tour –
available in English & Chinese
• Newborn Parenting
• Pain Relief Options:
Ask the Anesthesiologist
• Prenatal Yoga: 6-Part Series
• Starting Solid Foods
• Transition to Parenthood:
3-part series
• Twins, Triplets and More!
18
Childbirth Preparation (SLM)
Saturdays, 9 a.m.–2 p.m:
May 10
en Espanol:
Abril 12, Junio 14
1580 Valencia St., Suite 508C
Postnatal Yoga for Parents
and Babies (SLM)
1st and 3rd Saturdays,
11:15 a.m.–12:30 p.m. Free.
Prenatal Yoga (SLM)
Saturdays, 9:45–11 a.m. Free.
Thursdays, Gentle Yoga,
9–10:30 a.m., $110/10-class
card; $14 drop-in.
Reference Key
BHC = Brain Health Center
provides patient care, education
and research in the area of
memory loss, dementia, and
Alzheimer’s disease.
415-600-5555
Castro & Duboce, Level B
cpmc.org/brainhealth
Pregnancy and Parenting
Wednesdays, Chair Yoga, 11:30
a.m.–1 p.m., $110/10-class
card; $14 drop-in.
CHRC = Community Health
Resource Center,
your resource for accessible
health information and
support. Classes offered on
a donation basis.
415-923-3155
2100 Webster St., Room 106
cpmc.org/chrc
DIAB = Center for Diabetes
Services at California campus
offers adults individual and
group education sessions
for type 1 and 2 diabetes
self-management.
415-600-0506
3801 Sacramento Street,
7th Floor
cpmc.org/diabetes
DIAB* = Center for Diabetes
Services — St. Luke’s Diabetes
Center offers diabetes education
for pregnant women and adults
in English and Spanish.
415-641-6826
3555 Cesar Chavez Street
IHH = Institute for Health
& Healing classes teach
fundamental tools for wellness
and vitality. 415-600-1584
2040 Webster Street
myhealthandhealing.org
NBC = Newborn Connections
offers education and resources
for pregnancy, breastfeeding,
and parenting, as well as
a breastfeeding and baby
boutique.
415-600-BABY
3698 California Street, 1st Floor
cpmc.org/newbornconnections
SLM = Maternity — St. Luke’s
offers a variety of pregnancy and
childbirth classes, as well as
activities to supplement the care
provided by your physician.
415-641-6911
3555 Cesar Chavez Street
SWC = Sports Wellness
Center, where certified physical
therapists are specially trained in
sports and wellness programs.
415-600-5860
2360 Clay Street
cpmc.org/sportswellness
WHRC = Women’s Health
Resource Center offers
women’s health classes and
support, and boutique for hair
loss and breast needs.
415-600-0500
3698 California Street, 1st Floor
cpmc.org/whrc
MORE THAN NEIGHBORS
SAN FRANCISCO PARTNERS
What would life be like without partners? At Sutter Health, our primary
and specialty care doctors listen to you. And provide tools that connect
you and your doctor quickly—like email messaging, online medical
records, prescription refills and same-day appointments. And, when you
need to visit your doctor, we’re nearby with eighteen physician offices
and four CPMC hospital campuses throughout San Francisco. Because
partners help make life a little easier. It’s just another way we plus you.
cpmc.org
California Pacific Medical Center
Sutter Pacific Medical Foundation
19
Nonprofit Organization
US Postage
PAID
Sacramento, CA
Permit No. 195
P.O. BOX 7999, SAN FRANCISCO, CA 94120-7999
CALIFORNIA PACIFIC MEDICAL CENTER
NOVATO COMMUNITY HOSPITAL
SUTTER LAKESIDE HOSPITAL
SUTTER MEDICAL CENTER OF SANTA ROSA
SUTTER PACIFIC MEDICAL FOUNDATION
415-600-6000 | main CPMC phone
888-637-2762 | find a physician
cpmc.org
To be removed from the mailing list, please email
[email protected] or call 888-432-2762.
CHILD-SIzED ER FoR
Parent-sized needs
At Sutter Health’s CPMC, we’ve understood for years that kids are a lot braver
around other kids, and parents count on us for expert care. That’s why our
Pediatric Emergency Department, San Francisco’s first, gives kids their own
waiting area and pediatricians specially trained in emergency medicine. And our
Child Life staff helps families cope with emergencies, whenever they happen.
Helping brave kids get better. It’s another way we plus you.
Pediatric emergency department
415-600-4444
3700 California Street (at Cherry)
San Francisco
cpmc.org/Pedsed