Chrysalis Clinic Health
Patient Experience
HOME
TEAM
CONTACT US
  BMI
  calculator
Weight (kg)
Height (cm)
the hospital
To allow the safe, comfortable and humane practice of bariatric surgery, the Life Kingsbury Hospital
  • acquired a special operating table that is wider than standard tables and designed to carry up to 350kg.
  • acquired beds designed to carry weights of up to 350kg and having built-in scale and electronic controls to raise and lower the bed as a whole and its component parts.
  • acquired a hoist to lift very heavy, immobile patients.
  • acquired extra-long laparoscopes and laparoscopic instruments.
  • modified what was a two-bed ward into a single-bed ward with en-suite bathroom and toilet that were fitted with a floor-mounted, reinforced toilet, wide entrance door, reinforced hand rails and an extra-wide shower cubicle.
  • sent reception and nursing staff on sensitivity training courses.

As part of the nationally implemented programme of accreditation of ‘Bariatric Centres of Excellence’ at the end of 2007, Life Kingsbury Hospital was assessed by an international panel of experts. This panel assessed the facilities viz. hospital ward, equipment, documentation and staff. They complimented the hospital on its meticulous compliance with standards set out by the accreditation body. There is ongoing monitoring and collection of data to ensure that standards are being maintained.



coordinator


endocrinologists
The Role of the Endocrinologist:

An endocrinologist is a hormone specialist, with hormones being the chemical messengers that allow cells to communicate with themselves or other cells in the body. Hormones are therefore major players in the flow of information between cells and tissues, and endocrinologists are doctors who look at the functioning of various hormonal systems with a view to treating any malfunction. Endocrine problems are common in morbid obesity.

Dr Wayne May   Dr Hilton Kaplan  


dieticians

There is no doubt that anyone who seeks help from a specialized weight management clinic such as Chrysalis must have eating issues. Even though most of our clients are excellent ‘dieters’ and have indeed tried every diet imaginable, we find that most of them struggle to put their knowledge of what they should be eating into practice, and that although they may know how to diet, they do not know how to eat in a healthy, sustainable fashion.

Dietary intervention is a cornerstone of success both before and after bariatric surgery. Prior to surgery, modest weight loss and a balanced, healthy, low fat diet will not only start to introduce clients to the principals of what they need to be eating long-term, but is also important for the success of the operation. Patients are also made aware of the dietary restrictions that will be imposed after surgery, so that they can prepare themselves psychologically for these.

The diet required after surgery is radically different from one's usual diet. The surgical procedure is considered to create some malabsorption, and life-long follow-up and regular monitoring of nutritional status is essential in order to prevent candidates from, ultimately, suffering from the side-effects of this malabsorption, in the form of vitamin, mineral or protein deficiencies. There are also other side-effects associated with this type of surgery (nausea, vomiting, constipation), but, with correct dietary manipulation, these side effects can be minimised. Daily and life-long vitamin supplementation is vital, and is adjusted to suit each individual’s specific requirements.

The dietician not only teaches candidates what they can eat after surgery, but will also address psychological aspects related to eating. It is vitally important that candidates manage to overcome emotional eating, as the desire to eat in response to stressful situations will still be there after surgery. The dieticians on the Chrysalis team are trained in behavioural interventions to assist clients in learning how to adopt new eating habits.

Claire McMahon   Gina Fourie  


biokineticist
How the Biokineticist Prepares the patient for Surgery

The biokineticist helps each patient become comfortable with exercise and the spaces in which exercise in is done. Besides the obvious challenges of being overweight or obese in our world, when it comes to exercise, plus-sized people have even more obstacles in their way. There is intimidation at the gyms, which can be very scary places. The cardiovascular equipment in gyms can be confusing to use and may be difficult to use due to sore knees or back problems. Swimming is good exercise for obese people and is wonderful if you have a pool in your back yard, but walking around in a bathing suit can cause panic for many people, more so if you are overweight.

My role as the biokineticist is to get the patient comfortable with exercising, be it exercise done in the privacy of the patients home, or a one-on-one session in a quiet, private gym. Ideally, we recommend that patients have a few sessions with the biokineticist so that they can learn how to do the exercises correctly, and the Biokineticist can continually motivate them about the benefits of the exercise. If a patient is truly unable to see the biokineticist regularly, a home exercise programme can be put together and shown to the patient, for them to do in the comfort of their own homes. The biokineticist will do regular re-assessments and check-ups on these clients to ensure the exercise is being done.

For information on the benefits of regular physical activity, see the section headed Exercise Programmes.

Exercise requirements before surgery

For the patient to be considered for surgery, they have to comply with the exercise programme prescribed to them by the biokineticist. This is done either through regular exercise sessions with the biokineticist, or following a prescribed home exercise programme. Regular assessments will be done by the biokineticist to ensure compliance. Apart from all the long-term benefits of exercise mentioned in the section on Exerci

Mandy Banks  


psychiatrist & clinical psychologist
The Role of the Psychiatrist & Clinical Psychologist

The role of the team psychiatrist psychologist is to assess whether you are psychologically and psychiatrically well suited for, and prepared for, surgery. If you have any existing psychiatric condition, one or both of the mental health professionals on the team will assess and treat you until the problem(s) are sufficiently contained so as to not jeopardize your progress following surgery. Should you receive surgery, you will be expected to consult with the relevant clinician following your surgery to ensure that you remain emotionally safe and make maximum use of your new opportunities along your road to recovery.

Dr Kim Ragsdale   Graham Alexander  


critical care physician
The Role of the Critical Care Physician Before and After Surgery

Pre-operative Assessment:
In general, obese patients are at greater risk under anaesthesia and undergoing surgery. The critical care physician assesses fitness for surgery and determines whether the risk of surgery is acceptable or too high.

A full history is taken, followed by a thorough physical examination. Special investigations are performed. These include a full blood count, which checks haemoglobin (i.e. excludes anaemia), white blood cell count and platelets (blood clotting) and biochemistry (electrolytes and kidney function). Further blood tests may be necessary, for example if there is a thyroid problem or diabetes. A chest radiograph is performed to check out the heart and lungs and an effort stress test assesses overall fitness. Patients need to complete at least 6 minutes on the Bruce Protocol (3 minutes at 1.7 m.p.h. and 10% elevation, then 3 minutes at 2.5 m.p.h. and 12% elevation). This is the absolute minimum level of fitness required for surgery; ideally, the patient will be much fitter than this.

The physician then sends a report to the surgeon, the anaesthetist, and the general practitioner. Sometimes the Medical Aid also needs a report confirming that the patient is fit before authorising the surgery.

Post-operative Care:
The physician looks after the patient’s heart, lungs, and fluid requirements, together with any other special needs. Blood pressure, heart rate, and blood glucose are regularly measured and the appropriate medication is prescribed. In hypertensive and diabetic patients the blood pressure and glucose are often low postoperatively and regular medication may need to be omitted. Fluid intake and urine output are carefully monitored and adjustments to intravenous or oral intake may need to be made by the physician.

In the unlikely event of complications, patients may have to be looked after in the Intensive Care Unit. The physician is well equipped to deal with this situation as he is a registered Critical Care Specialist and fully capable of dealing with multiple organ problems in critically ill patients.
 

Dr John Turner  


surgeons


anaesthetists


physiotherapist
The Role of the Physiotherapist

Physiotherapy plays a small but important part in the patient’s recovery immediately post-surgery. As soon as the patient returns to the ward from the operating theatre, the physiotherapist is called to do breathing exercises with them and to get them out of bed for a walk, returning to a chair beside the bed. This early mobilization helps to prevent post-operative complications such as collapse of the base of the lung (atelectasis) or pneumonia, as well as preventing deep vein thrombosis or pulmonary embolus.

Celia Smith  


plastic surgeons