Dramatic Changes

Top Hospitals and Healthcare 2016: New holistic bariatric surgery program at Centra Lynchburg General Hospital.

Amy Casagrande, R.D., Diane Crane, Linsey Birt, R.N., Emily Kesler, L.P.N., and Joshua Alley, M.D.

Photo by Jonathan & Hannah Photography

Making the behavioral changes necessary for long-term weight loss is like “turning a cruise ship around in the ocean. It doesn’t happen immediately, it does take some time and effort,” says Dr. Joshua Alley, who introduced Lynchburg’s first bariatric surgery program in August 2015.

Bariatric, or weight loss, surgeries reduce the size of a patient’s stomach, which leads to a reduction in calorie consumption. At Centra Lynchburg General Hospital, Alley performs laparoscopic gastric bypass, sleeve gastrectomy and adjustable gastric band surgeries.

“Bariatric surgery is very different than it was in the ’80s and ’90s,” he says. Unlike the more invasive procedures of the past, most surgeries today are done laparoscopically, a minimally invasive surgical technique using small incisions and a tiny video camera. The camera transmits images onto a monitor to guide the surgeon.

The planning and lifestyle changes begin many months before the actual surgery, says Alley, who introduces candidates to the process during bi-monthly seminars. “It typically takes a patient about 3-6 months to work through the pre-surgical preparation.” 

The patient undergoes a psychological screening, to make sure he or she is ready for the major life changes involved with the procedure. They take part in group and one-on-one classes with a dietitian and begin a fitness program. Some take part in the affiliated Healthy Steps program at the YMCA, where a physical therapist and nurse monitor the patient during weekly workouts. 

Some of Alley’s patients begin the program “on two or three diabetes medications, two or three blood pressure medications. They’re very fatigued and just feeling like they’re worn out. It’s hard to start up in this program, but we get started with baby steps.”

The surgeries take about 1-2 hours, and are followed by a short hospital stay. Upon their release, most patients take about 2-4 weeks to recover and make their return to solid food. 

Follow-up appointments are important, especially in the first year, to make sure patients remain on track. “It’s not a one-and-done surgery where you have the surgery and then you’re out on your own,” he says. “We emphasize that this is chronic management of the obesity condition.”

Depending upon the procedure, and patients’ dedication, they typically lose 15-30 percent of their body weight, which can translate to 50-150 pounds for many patients. Some of them regain normal blood sugar levels and no longer need to take their previous medications for diabetes and other conditions.

“I’ve had patients who have gone on to run marathons and half marathons, triathletes,” says Alley. “You would just be blown away by their achievements.” CentraHealth.com/services/bariatric-surgery


Gastroenterology News

Dr. Jasmohan Bajaj, associate professor of Medicine at Virginia Commonwealth University, recently had his research linking gut bacteria and brain inflammation in patients with chronic liver cirrhosis published in the journals Hepatology and Scientific Reports. Dr. Bajaj’s findings conclude that certain bacteria found in the intestinal tract of humans and animals are associated with brain inflammation in patients with chronic liver disease. This inflammation can cause fatigue, mental confusion, and death. Dr. Bajaj’s research is being used to develop treatment options like microbial transplants from donors with healthy gastrointestinal tracts.

In May, the American Gastroenterological Association awarded Dr. David A. Johnson with the Distinguished Educator Award. Johnson is a professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk and has worked for more than 25 years in the field of gastroenterology.

Dr. Tamika Jaswani and Dr. Vu Nguyen, graduates of Virginia Tech Carilion School of Medicine’s new gastroenterology fellowship program, were selected to represent their hospital for the first time in the national GI Jeopardy tournament at the American College of Gastroenterology’s annual conference in Las Vegas last October. 

Earlier this year, Dr. Bhushan Pandya was elected president of the Medical Society of Virginia. Dr. Pandya is the founder and president of the Danville Gastroenterology Center and has served on the society’s board as associate director for more than 10 years. 


Gastroenterology Top Honors 2016


Mary Washington Hospital 
Fredericksburg, MaryWashingtonHealthcare.com, 540-741-1100

Fauquier Health
Warrenton, FauquierHealth.org, 540-316-2605

Bon Secours Mary Immaculate
Newport News, BonSecours.com/Hampton-Roads, 757-886-6000

Reston Hospital Center
Reston, RestonHospital.com, 703-689-9000

Bon Secours De Paul/Maryview
Hampton Roads, BonSecours.com/Hampton-Roads, 757-889-5000

See all of our top hospitals for 2016, below.



Cancer
LewisGale Regional Cancer Center
UVA Cancer Center


Cardiology
VCU Pauley Heart Center


Dermatology
Inova Melanoma and Skin Cancer Center


Diabetes
EVMS and Sentara Heart Hospital


Geriatrics
Riverside Center for Excellence in Aging


Neurosurgery
Bon Secours St. Mary's


Orthopaedics
Carilion Clinic 

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