A leap of faith . . . a leap of hope . . . a leap of health!

Part of the hospital's General Surgery Department, the Gastric Bypass Surgery team is led by Director Cmdr. Craig Shepps, Assistant Director Capt. James Prescott Flint and Coordinator/Case Manager Noemi Massari, RNBSN.

Patients who enter the Gastric Bypass Surgery Program are usually people who have exhausted every other means of losing their weight and now face serious medical complications if their weight isn't brought under control. They've tried all the diets and attempted exercise programs but they couldn't shed the pounds. This could be because of genetic or medical issues or from psycho-social behaviors developed from early childhood. Regardless, they now faced life-threatening illness brought on or complicated by their obesity. Sometimes it is their last hope.

Imagine how you'd feel if your doctor sits you down, takes your hand and says if you don't lose weight you're going to die but you know you can't do so on your own. On top of all that you carry the emotional baggage of low self-esteem fostered by years of guilt laid on you by friends, family, even strangers on the street. You've learned to hate that size zero, coat-hanger model who can eat twice her weight in French fries and never gain an ounce. (Cheer up; she may have some serious psycho-social nutritional issues as well!). Suffering and despair may have become the norm for you. You feel you have the cards stacked against you and you could use a re-deal.

General Surgeon and Gastric Bypass Program Assistant Director Capt. James Flint (left) performs gastric bypass surgery on a patient at a previous duty assignment. Flint said that he enjoys being able to help patients be around to watch their children grow up. "When we can guarantee that we can make that happen, the joy is palpable," he said. Photo courtesy of Capt. James Flint

You're not alone in this fix. Studies have shown that 13 million Americans are considered morbidly obese. Flint said this number is expected to increase, and there is no end in sight. In fact, today, 283 million Americans, approximately two thirds of the adult population, suffer from weight-related health conditions.

For many of these people the standard cures of diet and exercise can't realistically be expected to fix the problem. It is common knowledge in the medical community, as well as in the public eye, that the far majority of diets and diet programs cannot sustain weight loss in any significant fashion. People may lose a significant amount of weight, and this is great, but the trick is to keep the weight off. Many patients, who are interested in our program, recount this history of significant weight loss, but gaining it all back. These are the people who might be good candidates for the hospital's bariatric surgery program otherwise known as gastric bypass surgery.

The annual Gastric Bypass Program Pageant is an opportunity for patients to share what the program has done for them. The road they've chosen hasn't been without risks and challenges. The commitment they've made is for life.

Linda Herman poses in her pre-surgery clothing, size 26-32. In early 2005, Herman suffered from high blood pressure, asthma, allergies, high blood sugar and increasing pain in her back, knees and legs. She had limited mobility, needed support to walk and an orthopedist recommended she use a motorized scooter. Photo courtesy of Naval Hospital Jax

No one should consider this as their first option for losing weight. The hospital and the Wellness Center offer a number of programs that can help patients avoid such serious weight issues before they affect their overall well-being. These include nutritional and exercise programs. For information, call the Wellness Center at 542-5292.

More than 750 patients have been through the hospital's Gastric Bypass program since it was started in 1997. It's success has depended on the qualifications, experience and dedication of the surgical team as well as those who deliver pre and post-operative care.

Shepps is a general surgeon with experience in obesity surgery since 1979. He received his medical degree from Jefferson College in Philadelphia and completed a surgery residency at Naval Medical College, Portsmouth, Va. He has been the director of the program since 2004. Flint is also a highly skilled general surgeon, who earned his medical degree from the University of Florida's College of Medicine and graduated from the general surgical residency at St. Mary's Hospital in Connecticut, a Yale program affiliate. Since then, he has completed multiple advanced laparoscopic surgical programs and courses. He has a keen interest in laparoscopic surgery and all it offers.

Massari is a registered nurse and a member of the American Society for Metabolic & Bariatric surgery. She has worked with the program 12 years. She plays a vital role at this command and has developed a highly successful Gastric Bypass program. She has personally managed, directed and case managed over 500 patients in this program.

Massari also is in charge of coordinating the Gastric Bypass Program Support Group. She said, "This is an invaluable asset to the program in that it decreases patients visit to emergency rooms, clinics, the use of large amounts of medications, and helps patients become more active and thus more productive in society."

Three years after surgery, Linda Herman has been able to postpone knee replacements although doctors have discovered some heart damage from her being overweight. But now she's enoying life one day at a time and she feels better doing it. She still has allergies, is getting steroid injections for knee pain but is now using an indoor bike. Her weight is down to 177 pounds and she's gone from a size 26-32 to 16-18. Photo by Loren Barnes

The program also benefits from the support of other areas of clinical specialty within the hospital and available through TRICARE network facilities.

Shepps said that this annual event is something that he really looks forward to because it gives the patients the opportunity to show off the success they have achieved from a significant lifestyle change.

"I enjoy all aspects of being a general surgeon, particularly with active duty members who are deployed; but bariatrics is by far the most rewarding. The patients are profoundly grateful, repeatedly thanking me for giving them their life back! It is tremendously rewarding to be able to care for diabetes and hypertension and help these patients become happier and more productive members of society."

He will soon be changing duty stations but he will leave the leadership of this program in the capable hands of Flint.

Flint joined the team in August of 2007, when he arrived from Naples, Italy, but assisted in the bariatric program from 2002 to 2005 when he was stationed here before. In this kind of work, and especially in a hospital where individualized compassionate care is a hallmark, patients can't be just another 15 minute appointment. They receive individualized care which fully involves the patient, their families and all of Naval Hospital Jacksonville's provider assets.

Flint said he has enjoyed the special bonds that he has with his patients as they face the physical and emotional demands of the surgical experience.

He said, "People come from all walks of life, with a variety of experiences, but they are all here for the same thing, to lose weight and to improve their health. I love being able to describe the benefits of the surgery and sustained weight loss, not only for their health and well-being, but just as important, being able to share their long-term health with their families. I cannot count the number of times patients have told me that how they want to be around when their children grow up. It breaks my heart to hear that, but, I know it's true. When we can guarantee that we can make that happen, the joy is palpable!"

As a group the 12 patients in the show have lost hundreds of pounds since their surgery and they've discarded lots of old clothes. Many hold onto an item or two just to remind them of how far they've come. They exhibited some of these along with their "before photos" at the pageant. They also shared some incredible and courageous stories.

Kenneth Robinson prior to his surgery at 368 pounds. Photo courtesy of Naval Hospital Jax

Linda Herman came up against a brick wall in 2004 which forced her to make the decision to enter the gastric

bypass program. She had been suffering continually worsening knee pain and she had several other medical conditions which precluded her from knee surgery. On top of those she said most knee replacements aren't designed to support someone weighing 333 pounds.

When her doctor suggested she use a motorized scooter, she knew that just wasn't going to work for her. She felt that if she did that she would never be active again. She had her surgery in February of 2005 and she now weighs 281 pounds.

She is no longer taking medication for hypertension, gastric reflux or using her inhaler daily. Herman's philosophy is that of a survivor. "You keep putting one foot in front of the other and you get through it," she said. "My life is entirely different. There will be good days and bad days until I get my knee replaced."

The hospital's support group is a key element of these patients' recovery process. Lorena Mack is a sponsor for new patients entering the Gastric Bypass Program. She had her surgery in April 2004 and weighed 250 pounds. Today, that's down to 132 pounds, a 118 pound reduction. The 52-year-old no longer needs blood pressure or heart medications.

Lorena said that as a sponsor, "I give them a reality check from the patient's point of view rather than of the surgeon. There are often questions they will ask another patient that they won't ask a professional."

Patient Kenneth Robinson and his wife, Nancy, who works in the Naval Hospital's Family Medicine Department, at the fashion show. Robinson who once weighed 368 pounds is down to 202 pounds. His clothing size has gone from a 58 waist to size 38. Inactive before the surgery, he now walks three miles daily and rides a bike. Photo by Marsha Childs

Most men think of a fashion shows as "a woman thing." But 54-year-old Ken Robinson, is proud to show off his new look. But what he's really happy about is what the gastric bypass program has done for his health.

He said, "The greatest benefit is just being here today. The biggest benefit is medical." Robinson no longer takes any medication and he can shop in a regular store and buy normal clothes. Another benefit is not using an extender seatbelt when traveling by plane he said. Robinson's wife, Nancy is a nurse in the Naval Hospital Jacksonville Family Medicine Department. She remains a source of encouragement for him and the other patients in the program. Ken had abdominoplasty in August 2007 to remove his excess skin after repeated infections.

As all these patients can attest, Gastric Bypass Surgery patients soon learn that achieving that "new you" involves more than just the physical results of the surgery. It involves a complete lifestyle change.

Flint stresses that not everyone can become a candidate for the program, but that anyone who is morbidly obese and interested in bariatric surgery, should speak to his or her primary care provider about the program. We have strict criteria for entering the program, but there are many people who are perfect candidates, but are never referred.

"Until the mainstream media and the mainstream medical community jump on board the bariatric surgical express, patients are to have to do their own investigating, and ask that they be considered for the program, as long as they meet the criteria. Sometimes, you can't just sit back and let things happen. Just like in our program, sometimes, you have to work for your health," said Flint.