Making A Difference: An Interview with Dr. Raymond Taddeucci
December 8, 2012Making A Difference: An Interview with Dr. Raymond Taddeucci
An OH Magazine Interview
Do you ever wonder why your bariatric surgeon chose their profession, or why he or she cares so much about the fight against obesity? Or perhaps you have other questions you would ask? OH Magazine recently had the opportunity to interview Dr. Raymond Taddeucci and we asked some of the very questions you might have wanted to!
OH: Hello Dr. Taddeucci. What factors influenced your decision to become a bariatric surgeon?
Dr. Taddeucci: When I started my fellowship I had really no intention of doing bariatric surgery, but bariatric procedures comprised about 90 percent of what I did as a fellow. That gave me the opportunity to see long-term results in patients and the great benefits that they had.
OH: Can you share with our readers what the difference is between caring for the bariatric patient versus a general surgery patient?
Dr. Taddeucci: Well, with the general surgery patient, we typically we see them once or twice post-operatively and if everything goes well, you may never see that patient again. With bariatric surgery, routine follow-ups are essential to a patient to do well in my opinion, so we may see a patient five or more times in that first year. After that first year, we recommend a patient follow up with us at least on an annual basis. I really get to know the patients, and each time they come to see me, I learn more about them. So my bariatric patients are more acquaintances rather than just patients.
OH: Can you tell us about some of your strategies that you and your team might utilize to support patients through issues that are most often compromising towards health and weight loss?
Dr. Taddeucci: I guess you have to differentiate between a pre-operative and a post-operative patient. One new practice we have started recently for our pre-operative patients is a physical therapy evaluation. The problem with a lot of bariatric patients is that they’ve never exercised, or they’ve exercised very little, or are limited in what they can do. They may feel that they can’t exercise because of joint pains or back pain, for example. One of the problems was that after the surgery, it was hard to get some patients to start exercising, even more so if they were not doing well post-operatively in terms of weight loss.
What we now have our patients do is see a exercise physiologist who has an arrangement with our group in that he’s very supportive of bariatric surgery and very supportive of what we’re doing. He will evaluate all of our patients and determine an exercise routine they can carry out after the surgery. So for example, someone who may not be able to ambulate well, it may be doing certain exercises with their upper extremities. Therefore, they can have a starting point. That’s something that we’ve just started and it looks like it’s going to work very well. It’s just one more tool to help the patient be successful after the surgery.
So after the surgery, we recommend that exercise regime that has been developed for them. If the patient is struggling after the surgery, I think it important to determine the trigger. Whether it’s a family problem or it’s a work problem, we have to identify the stressor. The patient needs to be able to admit where the failures are occurring. Once we determine what the stressor is, we can work on overcoming it. We always recommend support groups. We also may refer them to the dietician they saw pre-operatively and sometimes the psychologist they saw pre-operatively. I always say, surgery is only about 20 percent of the battle; the other 80 percent is all about behavioral changes. That is absolutely the most difficult part after the surgery. It is maintaining control over those mental battles.
OH: Many of your patients have experienced weight bias in the health-care field. Can you tell us about what you have observed?
Dr. Taddeucci: As far as bias in the actual hospital setting, I can’t really recall any episodes here because I think that our hospital, as far as its sensitivity training, I think that it’s been very thorough and I think everyone is very much on board with bariatric surgery. That’s part of being a Center of Excellence. What I probably have seen more of is, occasionally, we’ll have primary care physicians who aren’t supportive of our patients having weight loss surgery. I think the reason for that is because they are basing their opinion on outdated information or experiences. Even I am surprised and dismayed at times about some of the procedures done 20 or 30 years ago. However, the field of bariatrics has changed substantially in the last 10 years. So I tell my patients that if their primary care physician is not on board with weight loss surgery, then find a physician who is. I find it hard to believe that in 2012 there are physicians who don’t believe in weight loss surgery. To me, that’s like saying you wouldn’t buy a car in 2012 because the car you owned in 1985 was unreliable.
OH: What do you think of the future of bariatric surgery? Any up and coming procedures or any studies you’re aware of that you’d like to share with our readers?
Dr. Taddeucci: Everyone is trying to find a safe procedure for weight loss and even though gastric bypass is still technically the gold standard, everyone is working like crazy to find a procedure other than the gastric bypass that can be done and that is safer in the long-term. Right now, there’s research with intraluminal procedures through the mouth. But, I think we’re far from any of those being really very successful. And for me, I think the sleeve gastrectomy looks very promising. I think it’s a simple concept, and the results I’ve seen so far in my patients have been very encouraging. I think it takes away a lot of the long-term risks associated with gastric bypass, and it’s much more predictable compared to the lap-band as far as weight loss after the surgery.
OH: Is there anything else you’d like to share with our readers?
Dr. Taddeucci: Surgery is just a tool to allow patients to become more physically fit. Physical fitness does not just mean eating less and losing weight, but also exercising. All of my patients who are doing very well are exercising, and all of my patients who are struggling are not exercising. I guess I find it hard to understand how a patient is unhappy with their weight loss, yet is not exercising. Marathon runners don’t just go out and run a marathon. They train nearly every day in order to be able to do that. So while a morbidly obese person may look at that marathon runner with envy, they also have to understand that a lot of work goes into getting to that point.
For more information about Dr. Taddeucci visit http://www.weightlosssurgerylincoln.com/ or his OH profile here.
