Metabolic Bariatric Surgery – The Full Run Down
Trish
Hello, listeners. It’s Trish Hammond here again from the Transforming Bodies podcast. And I’m really excited about today’s podcast. It’s something a little bit different for us. So today, I’ve got the pleasure of speaking with Professor Michael Talbot. Now Dr Talbot is a Specialist Bariatric Surgeon. Well, actually, he’s a Specialist in bariatric surgery, upper gastrointestinal surgery, therapeutic endoscopy, esophageal physiology and I know you became an Associate Professor in 2015 so congratulations. I’m really excited to be speaking to someone about this today. So tell me, first of all, what made you because obviously, you became a doctor years ago, but what kind of guided you into the direction of bariatric surgery?
Dr Talbot
I had it in bariatric surgery becoming interested in bariatric surgery towards the end of my surgical training in Australia back in the late 2000s. It was being done a lot overseas. And there are a lot of publications and a lot of centres getting really good results, yet the perception in Australia and Sydney at the time was that people with weight problems were people that you couldn’t help and couldn’t treat and you shouldn’t try to treat or show them. The perception was that it was a self-inflicted lifestyle choice with mainly psychological of tones rather than a disorder of body function that you could help people improve by altering aspects of their body function but the studies overseas seem to indicate that what we were doing was wrong and that other people in other places had better ideas. So when I went overseas to do some extra surgical training on the return, I visited a whole lot of these units that were doing this sort of surgery. So when I arrived back in Sydney and started working as a consultant in 2003, there was really nobody doing weight loss surgery and trying to get it done in public hospitals with uninsured patients, trying to look after people who needed help, but perhaps couldn’t afford it and that’s really when it started. The surgery itself is technically very challenging and very interesting and the patients are great fun to work with because most people who’ve had a long term weight problem have experienced multiple failed treatments, and I’ve been told that the cause of the failure was them not the treatment. We knew all along the treatments didn’t work, whereas you can offer people surgery and now other therapies. And people get better. They wanna get better. You give them the tools to get better and they get better. Who would’ve thought?
Trish
Yeah. Exactly. And you know, so obviously, what you’re explaining to me is, well, is, like, which is only kind of something that’s come about recently, I believe, because I’ve been obese most of my life except for now and it is a chronic disease. Isn’t it?
It’s a disease, it’s a sickness.
Dr Talbot
We knew that it was a chronic disease 20 odd years ago. All the data showed that it was a chronic disease but there was a pushback driven a lot by governments and government health services and insurers who were not that interested in paying for healthcare, for people living with obesity, that it wasn’t a chronic disease, even though every single study. So we had parallel medical systems. There was a data driven medical system where there was a lot of study about the causes of obesity and treatments of obesity, big society studying and treating people with obesity, but they were cut off as much as possible from mainstream medicine and the ability to access treatments because of this alternate belief that it’s not a disease, that it’s a choice, even though all of the data chose it to chronic disease. Nobody has ever been demonstrated to experience spontaneous remission of severe obesity. It’s not an event that’s ever occurred.
Now there are people whose severe obesity has improved significantly with intensive treatment, but that’s not the same as spontaneous remission. The disease doesn’t go away. You can and we’ve known that forever. But despite knowing that it’s there forever and to treat it forever, you need forever treatments. There’s been this disconnect, but that’s how people think, people do these sorts of things.
Trish
Totally. And I don’t know. I’ve always thought that having been and coming from a family that is just natural, naturally obese. I’ve always thought that people that are in that category have always been looked upon as lesser of a human being in the sense of, not you like, obviously, I think you’re not respected as much and all that sort of thing. So it is a real problem, and I just wonder sometimes because there’s so much available out there these days, a lot of people don’t reach out because number 1, they don’t know it’s possible. Number 2, which is how I thought I was really scared about bariatric surgery because you heard all these things and stuff like that. And in fact, years ago, my mother passed away now, rest in peace mum, but she was obese, most of her adult life. And in fact, ultimately, that led to her death, the results of health issues because of that but she was off of this surgery years ago and she was too scared because she’d heard so many things about it. But these days, it’s a little bit different, like, not a little bit different, but I think it’s a bit more widespread where we’re coming and sort of learning more about it. So there are different types like you mentioned. You have lots of different options for people that have these issues. But could you just touch on the different types of like I guess you would call it metabolic surgery?
Dr Talbot
It’s what it’s called these days. We’ve changed the term from bariatric surgery or surgery for weight or obesity surgery, surgery for a basic to bariatric metabolic surgery because we’re acknowledging that there’s 2 conditions. One is a condition associated with carrying excess weight, which leads to functional problems, joint problems, sleep apnea. But there’s an underlying metabolic disorder as well, which increases significantly chances of heart attack stroke and many cancers. And so as the data got better, we’ve realised that it’s a twin trap disease process and some are more affected by one heart than the other. So some people can be really very heavy and metabolically quite sound. And what happens to them is their joints just wear out when they get older and other people can be not merely as heavy, but metabolically very unsound and they can get all these other conditions at a low weight. But the therapies work equally well for both conditions. So if you’re very heavy, it will help. If you’re not as heavy, but have just got a whole lot of metabolic problems like diabetes. It helps equally well.
Trish
Well, how I actually came across or more or found out about you with the fact that I have a friend in one of our groups who’s actually going through a procedure with you, and she reached out to me and said me, oh, I’m jumping on a webinar to find out about this surgery. Do you wanna join me? And I was like, yeah. I’ll definitely join you because I’ve actually had the surgery or I’ve had to get straight sleeved myself about five years ago. And and so I thought, oh, yeah, this sounds great because I never really did. I did a lot of research before, as you know, who I should go and see and to speak to them. But I’ve never actually done research about pre, the during and the post surgery. And here I am, like, 5 years later and I still eat, not not very well, but, you know, I maintain a certain level of weight. So I jumped on the webinar and of course I was like, oh, wow. This is just amazing. So I think one of the things that became really obvious to me is that sort of big before stuff is essential, the during stuff is essential, and the post information that she has that’s gonna happen afterwards is so essential. So can you tell me a little bit about how, like, why it’s so essential to have that follow-up session. The fact that you’ve got, like, you’ve got a multidisciplinary team that you work with and why that I mean, I know why now as a result of that? But why is that going to work a whole lot better than just going and having surgery and you’re done?
Dr Talbot
There’s a whole lot of issues. One, it keys into motivation when somebody makes a decision, a hard decision to consider a complex treatment like surgery, they have a reason or a motivation for it and keying into that motivation and knowing what that motivation is helps the care team to reflect back to the person having the treatment, what it is that they want to achieve and why it’s important to them. Also, when you see people beforehand, you get a better idea of their goals and you might have an easier ability to just to help them decide which therapy is going to be appropriate for them because there’s multiple different treatments. And often the selection of treatment is determined by the preference of the clinician rather than necessarily the preferences of the person seeking treatment. So, you know, if you go to a CocaCola shop, you will get CocaCola. If you go to a shop that sells CocaCola Pepsi and smoothies, you might walk out of the shop with a different range of options. And so knowing what people want and what to achieve is motivation and selection, but then also trying to engage with people to have long term follow-up. We know that all of these procedures work very well in the long term, 5, 10, 15, 20 years because we’ve got studies where people have had surgery sleeves and bypasses and what have even been prospectively followed to gauge their outcomes. And what we do know is that there is a rate of weight regain that occurs in people that patients who stay in follow-up, that weight regain is always small. People who are not in follow-up can have a very wide range of outcomes because nobody’s offering them advice and holding them accountable and reminding them that weight management is very important. So everybody knows somebody who’s regained weight after weight loss operation. And I talk about it incessantly, but they ignore all the people who haven’t regained weight after weight loss operation. And I’ve ignored the reasons why somebody might regain weight after weight loss operation. And a lot of it’s just related to people snipping back into old habits of ignoring their weight and their health and pretending that it won’t be a that it’s not a problem anymore. When relatively simple things can be done to help people to prevent, like, regain, and then for the problems.
Trish
You’re right about the account for this because I do, of course, know someone who had a gastric sleeve, although she had quite a bit of weight to lose and she’d lost weight, but then she’d put it back on. And I also know that she had no follow-up, but also the things that she used to do. So, like, she used to mash up chocolate and, you know, like, all these sort of crazy addiction things. I guess, like someone who’s addicted to food or chocolate or whatever and obviously put that on them.
Dr Talbot
And she’ll be disappointed with herself. And if she’d been offered therapy towards managing some of these addictive issues and a bit of holistic care, the team may have been able then to find a way out of it. Not everybody who has an gets out of it. But we know from treating all other addictions, you know alcohol, cigarettes, and drugs that there are successful programs that people can enrol in. And most people are very interested most of the time in escaping from these behaviours; they just feel trapped. So what they need is the offer, the opportunity to get these treatments when they are needed. Offering somebody, you know, addiction therapy before weight loss surgery is a complete waste of time. Because not everybody will need it, but being aware that some people will after surgery and will have struggles. You can then individualise your care to the needs of that person.
Trish
Yep. That’s so true. And I love the fact that you’ve got a real, tailored, patient centred care, for your patients like it. And I know that every patient is different as well. But could you tell us a little bit about the different types of metabolic bariatric surgery that are available or that you offer or do you offer all the types that are available?
Dr Talbot
I offer most. There’s some things I do less frequently than others often because the patients seeking those therapies are not within the demographic of people that I normally see. So looking at interventions where the whole point of an intervention to help with weight loss is to change physiology of your appetite and your metabolism to make it easier to lose weight either by eating less food or if we’re lucky, increasing in metabolic rate. So on the easy end or the more simple end, there’s you can do endoscopic procedures on people to manipulate their appetite. So there’s a group of procedures called Intragastric Balloon. So you put a temporary device inside somebody’s stomach for 4 to 12 months, and that allows people to lose 10, 12 kilograms or so relatively quickly and easily. The problem with that is that most people when the therapy ends, eighty five percent of people regain a lot of their weight. So while that is a therapy that some people choose because they feel that they’re young enough or active enough that if they lose some weight, they can keep it off. It’s generally not part of the suite of services that I offer because I tend to get people further down the track. But occasionally, I do them.
I’ll find somebody who’s interested in that as a way of giving it a last go. Saying, look, if I can lose the weight, if you can get me to lose the weight, I can probably keep it off. Well, best of luck. It might work. I mean, I’m not gonna say it’s not gonna work. The main thing is a predisposition to regain weight. It’s not the same as predetermination. It’s not fated that you’ll definitely regain weight. It’s just a high risk that you might. There’s another procedure called an endoscopic sleeve gastroplasty where a suturing device is used to make the stomach smaller. And that’s been around for about ten years now, and it’s taken quite some time for the results to be good because what often happens is that the sutures get spat out eventually, and then the person regains weight. But these days, for people who want sort of a 15 to 20%weight loss, that might be lighter people and younger people. That’s a non surgical option, which probably won’t last forever. In fact, probably for most people, they’ll start to get, like, regain after 3, 4 years. But it’s another option that’s effective and then people can use that combined with lifestyle therapies.
Trish
What’s that one called?
Dr Talbot
ESG, Endoscopic Sleeve Gastroplasty. Mhmm. It’s not, it’s not sort of fallen out of favour a bit because it’s very expensive and because of the white regain that occurs with a number of people that doesn’t generate as many good stories. So if you do it on a sleeve, for example, on 50 people, you’ll get 48 people who lose an enormous amount of weight and achieve their weight loss goals and be happy. And then they go out and tell their friends, whereas if you do fifty ESGs, you might get 10 or 15 or more people who really struggle to lose any weight and feel a bit disillusioned. And then there’s less 5 year old people down the road like yourself. You’d had a sleeve and you’d and it had stopped working to find out the 5 year mark, you’d feel a little bit disappointed. But the results for the year are getting better, and I suspect it’s going to make a bit of a return sometime over the next couple of years. Now that the procedure is more polished and it’s a hard procedure to do, we’ll probably end up seeing more people having that. The next lot of procedures, and I should actually backtrack a bit. When we talk about weight loss, we’re trying to gauge the effectiveness of the procedure. We know enough about the therapy to be able to tell somebody before they have the treatment. What the average outcome is. Because we’ve got data from hundreds of thousands of people. And the term we use is percentage weight loss. So if you’re 100 kilograms and I give you a therapy that averages a 10% weight loss I’d expect you to lose 10 kilograms on average. Now, everything’s on a bell curve of distribution. So some people, while the average might be 10 kilograms, some people might lose 15 or 20 kilograms, but maybe only 1 in 4 people might lose that much of 1 in 5. And conversely, 1 in 5 people only lose 3 or 4 kilograms. Because the therapy is not as effective for them. So as you lift the average weight loss you pull the ground up. So the poor weight loss group became better. So a sleeve gastric to me, which is Australia and the world’s most popular procedure on average, gives about 30 to 32% weight loss so somebody who’s 120 kilograms, who loses 30% of their weight, expects to lose about 40 kilograms. Okay. If you think that most people having surgery are around that 110 to 130 mark, the sleeve hits the sweet spot. Now I might say your average weight loss might be about 40 kilograms. You might lose 50 kilograms. You might lose 30 kilograms. But probably less than 1 in 10 people having a sleeve will lose less than 15% of their starting weight. So if you have a sleeve, you might not go from 120 to 80, but you’ll probably at least get to a 100. Whereas other treatments the people who don’t do as well can feel more disappointed, and you’re really hoping with a weaker treatment to be the lot opener so if I put you somebody on a diet, I know that the average weight loss is 3 to 4% weight loss. But I also know that one in yeah. That’s what it is. We’ve done that for years. There’s massive studies, so there’s a really good one from looking at I think Jenny Craig where 80,000 people were enrolled in the diet, and the results are the same for all of them. And at the end of a year and a bit, the average weight loss was 15%, but only 1 in 5 people achieved so only 5% of people achieved that weight loss. Everybody else didn’t achieve weight loss.
Trish
I was one of those.
Dr Talbot
So you enrolled 80,000 people, 5% of those 80,000 people will achieve a good weight loss. Because they have to be at the very top of the bell curve. So the other 97% or greater than 2 standard deviations. But for every person who loses 5 kilograms, there’s another poor sucker on the other end of the bell curve who’s gained just as much during the diet. Bypasses, and there’s many different types, average about 40% weight loss.
Trish
Okay. But that’s someone who’s got a significant amount of weight.
Dr Talbot
Yeah. Because, again, if you think about it, if you’re 120 kilograms and you lose 30% of your weight, you’ll get down to 80. If you’re 120 kilograms and you’ll lose 40% of your weight, you might get down to 75. Yeah. It’s statistically measurable, but may not be significant, especially since the bypass procedures do care within a long term greater side effect profile and greater input from the person having surgery to maintain safety.
Trish
Yeah. Okay. So it’s basically the Balloon, ESG, Gastric sleeve are different varieties of bypass.
Dr Talbot
And there’s a lot of funny thoughts about the different bypasses. But they’re very similar in results. It is they’re all slightly different in side effect profile. So you can select a different bypass for a different individual based on where you feel their risk for side effects might be. So somebody, for example, with absolutely terrible reflux, might not want to have a mini bypass or a mega loop bypass or band bypass, because the risk of reflux is slightly higher.
Trish
Okay. Got it.
Dr Talbot
Somebody with a whole lot of adhesions or chronic abdominal pain might want an amyloid bypass rather than a ruined bypass. Ask because the risk of abdominal pain is lower and bowel blockage is lower. So you can juggle.
Trish
Yep. I love the fact that you’ve got all those options because some people, like, first of all, I had surgery and you had one option that was all that doctor did. That makes sense, whereas you can customise this to each patient, which makes so much sense. And also like having actually, one quick question. So if you’d had a sleeve and it hadn’t been a successful one, could you have a bypass after that?
Dr Talbot
Yeah. You can change the procedure. So the thing about the procedures that we have is the larger procedures recruit more mechanisms of action. So you might say using a similar analogy that an ESG is like having a simple, Amoxicillin antibiotic, a sleeve is like having a powerful modern antibiotic tablet. And a bypass is like having an intravenous drip for an antibiotic. But so the power increases, but with the increasing power, you get an increase in potential side effects associated with each of those therapies.
Trish
Yep. That makes so much sense. And tell me so, after surgery, because I was told that I need to take multivitamins after surgery for the rest of my life. And of course, Yep. I did for a very short time, and I don’t anymore. So but having spoken to my friend since she’s spoken to you. Oh my god. I need to start taking my multivitamins.
Dr Talbot
Okay.
Trish
So can you tell us why? Because like I like, I feel fine. My blood tests are all fine, but she’s talking about she’s saying to me it’s about absorption and, like, so, look, my blood test looks alright. I think, why do I need multivitamins? But I’ve only got a nervous stomach.
Dr Talbot
You got less than half the stomach. So in the days before multivitamins were available, the rate of irreversible neurological complications such as early dementia, and slow growing paralysis. So it’s about 12% or 15% of people having gastric surgery. So the gastric surgery hasn’t changed. The main reason why we’re avoiding those sorts of problems and a lot of people is because we’re monitoring things and getting people treatment. And there’s no guarantee that the modern diet is going to allow you to avoid these problems. And at least 1 to 2% of people who have bariatric surgery in Australia will end up with permanent injury associated with a vitamin or mineral deficiency. And even though people are often having their levels checked, they’re almost never having the levels of the dangerous things checked. So you might have just your Vitamin D checked, which is fine, and it’s good for bone health. But unless you’re checking your Vitamin B12 and vitamin levels, you don’t actually know if your vitamin levels are safe. You don’t actually know if your Vitamin C levels are adequate. At least a third of people in parts of Sydney have low Vitamin C levels, which is kind of like scurvy. You don’t know that that’s the case. And unless you check all those levels and most people don’t. So a multivitamin is like an insurance policy. So if you’re gonna think about cost effectiveness, given the massive cost of all of these screening blood tests and given that we’re screening blood tests in order to pick up people who have vitamin and mineral deficiencies and the treatment of these vitamin and mineral deficiencies is cheap and effective. Kinda seems pointless. Wanted to give people an insurance policy, and then not worry about it. And then not spend as much money on screening for it. So big ticket items are Vitamin B12 and Vitamin D and bone metabolism. So when you have a small stomach, you don’t put acid in your food as much. So all of the things that you need acid to improve your absorption are no longer absorbed as well. So iron, calcium, magnesium, Vitamin B12, and some other vitamins. So your efficiency at absorbing those things is lower than it would have been if you hadn’t had surgery and you might have a very efficient system. So you may not need the multivitamin. But you don’t actually know whether you do until some months or years are to the surgery and then it might be too late.
Trish
Yep. Well, that’s just scared the crap out of it because I know you might plate your vitamins, and I need because your body didn’t absorb them, but I didn’t really know. So that’s wonderful.
Dr Talbot
And the other big plug is calcium and bone. So if you’ve had a weight loss operation, I can guarantee a hundred percent that one day you will get bad osteoporosis. I guarantee it. I just don’t know when it’s gonna happen. So, taking extra calcium may help, but it actually may not. Calcium that you take with your diet or supplements may reduce but may not reduce the amount of bone loss you have over your life, but it won’t make your bones stronger. So calcium doesn’t make your bones stronger. It just might slow down the rate of them becoming weaker. So every person who has weight loss surgery, if they become pregnant, they need calcium. And when you start heading towards menopause, you start needing to have second yearly bone density scans and you need to do weights.
Trish
Mhmm. Right. You know, we’ll be going this afternoon.
Dr Talbot
Right? So you see. But all these things occur, you see. And if you see people in follow-up, 10-15 years after surgery. That’s just a simple conversation. I can say, how old are you now? Okay. Well, you need to do this. And it’s a very simple fix: the cost of a bone density scan is something like 50 bucks on Medicare. You could pay for it and not worry about the Medicare cost. Because it’s so cheap and effective, and it’s such an easy thing to do. And if you knew that you were gonna get osteoporosis, and start snapping bones when you have a coughing fit, then you’d just take something for it. But if you don’t know. You can’t do anything.
Trish
That’s so true, knowledge is power, especially in the system though.
Dr Talbot
Nobody ever struggled because they knew too much. It just gives you more opportunities to make good decisions.
Trish
Yeah. I’m screaming in my seat here, but I am actually going downstairs on Tuesday. So I’m like, I’m right. I’m just gonna get my stuff in order. So tell me so but what about the safety and risks?
Like, we’ve talked about the benefits, but what about the risks, I guess, on the safety side of it?
Dr Talbot
Look, the surgery itself is very, very safe. So if you think about the first 90 days after an operation. Sleeve gastrectomy is in gastric bypass, in most individuals. I mean, some people carry extra risks because of their extra health problems. So in nice individuals, the risks of having a sleeve bypass are pretty much the same as having a keyhole hysterectomy or a keyhole gallbladder removal. So it’s that level of risk. And that’s, therefore, an order of magnitude safer than having a knee replacement or a hip replacement or an angiogram. You are far more likely to die or suffer a major prolonged illness associated with these types of surgeries than you are with the sleeve bypass. The issue is that the risk is low, but it’s not zero. And some people carry extra risks. And if you’ve got kidney failure or bad heart failure associated with your life problem, then your risks are gonna be higher. Your gains are high because you can get rid of these terrible diseases, but your risks are high because you’ve got to pass through the gauntlet of having the procedure done. But for anybody who has the surgery, I might say, look, the risk of an infection is 1 in 500. But if that happens in the news, it’s 100%. That people don’t really understand the whole concept of statistics. They kind of understand it, but they sort of don’t. So people worry a lot about very small current risks and discount very large future risks, which is another thing. So once people have gotten over the 90 days of surgery, they believe that they’re in the clear and they can stop thinking about it. But then reality weight loss surgery is like owning a car. If you don’t do a yearly service on your car, one day it’s gonna stop while you’re driving to work. And you probably won’t be that surprised.
Trish
No. No. That’s so true to that. And that makes so much sense. It puts it all into perspective as well. And I know we’ve gone over time. I’m really sorry about that. But I wanna ask you a more question because tell us about your webinars because that’s how I met you and I actually asked you this question during that webinar, but actually before you tell us how many surgeries have you done?
Dr Talbot
Oh, I’ve got no idea. I used to pay attention to it in the early days. You know, I wonder if it’s possible. I think maybe I was one of the first people to get to a hundred sleeves in Australia.
And, you know, that sort of stuff mattered because I knew early on that there was a rate of side effects and complications and that you needed to get to a large number to have a feel for what your side effect and complication rate was. But after that, I stopped counting. But I guess, I’ve done at least a couple a hundred a year since 2003-2004, something along those lines.
Trish
So that’s what it was a thousand.
Dr Talbot
But they’re all individuals. So one thing about aiming for numerical supremacy and saying, oh, yes, I do a thousand a year, is that if you do too many, you lose traction on treating people as individuals. So there’s a number that you need to achieve to be competent and happy. If you try to aim for too many, then it’s just a factory. And you lose connection with the outcomes that you have with your patients. And again, that’s another reason why follow-up is so important. If you don’t, if you’re not seeing people 5, 8, 10 years after the surgery, How on earth will you know if you’re doing a good job?
Trish
Yeah. That’s so true. That’s so true. And for me, it wasn’t more about the numbers. It was more about saying, oh, you hey. You’ve done so many things. You know what you’re doing? You have to be so many.
Dr Talbot
I’ve practised. Yes. Absolutely.
Trish
So just to finish off then, if you don’t mind it, just give us a nice to like, you do a webinar. It’s once a month on a Monday night at eight o’clock.
Dr Talbot
Yeah. So I share that. Actually, one of my colleagues who works in practice does more than I do. I feel it when he’s not around. But, yeah, we do a webinar. Basically, for a lot of people, it’s a big deal to make an appointment. To sit there and bear your soul to an individual and express your failure. Because that’s what people believe that they’ve failed and they’re turning up because they’ve failed and they’re pretty miserable about it. So it’s a big step for people to go to an appointment and have a conversation about a weight problem. And the nice thing about a webinar is that it’s arm’s length. You can have the camera off. You can just listen, ask questions. It’s anonymous. You’re not revealing yourself to the clinician. The clinician is revealing themselves to you, and then you can think about it. You don’t have to be ready for surgery. You just wanna find out about it. Whereas, to turn up for an appointment, it’s a big commitment because you’re saying I am doing this. You may not know if you’re doing it. You may not know if it’s the right thing for you.
Trish
Yeah. Although, I think if someone once you’ve come to the appointment, you’ve already done like, if these days, people have done their research well, most of the time, they’ve done their research you know, they’ve researched the life out of what they want. They kind of like, they know. A lot of time they get to you.
Dr Talbot
Because I know that’s the case, but I would actually like to get people earlier because then that means that they can get their family involved. You know, if somebody wants to have surgery, but they don’t know how to explain it to their partner or their brother or sister. Then they can just sit in the corner and listen to this and tell me what they think. So it allows a graded distance from commitment which I think suits people at different stages of their approach.
Trish
And do you so your website, it’s uppergisurgery.com.au, and where are you based?
Dr Talbot
So home based is in Southern Sydney in Kogarah. We do work all over the place. So up as far north as St Vincent’s, as far south as Wollongong. I go out to Orange occasionally as well and one of the guys in the office is down there, Golden as well. So we’ve seen people all over the place. Because it’s often very even with Telehealth, it’s quite nice to be able to see people face to face at times.
Trish
And I know there was going to be a last question, last question, but seriously last question. So if someone was having, say, the bypass. What would be the recovery time? So you’re going to hospital and you’ve already done your preparation for a few weeks or how long is it?
You’re going to the hospital. How long are they in hospital for?
Dr Talbot
It’s actually for sleeves and all the bypasses. For most people, it’s identical. The hospital staying in process is getting up to the same. You come to the hospital the day of surgery. The surgery may take an hour and a half, but the whole process of going in, having surgery, waking up, and going to the ward takes half a day. And then people usually go home and stay in the hospital for 2 nights. You can, in fact, stay in the hospital for 1 night if you feel like it. But a lot of people don’t wanna go home the following day. They want to make sure that they’re fully competent in mobile before they go. So it’s often 2 days, but you can do it as an overnight stay. If people are highly motivated and well supported at home.
Trish
Yep. Recovery at home. You reckon, like, how long before you could move around at home and
Dr Talbot
Most people can drive within a week. And go back to work within 2 weeks. People who are self employed or control their working hours are usually back to work within a week. But conversely, if you do long shift work, especially physical work, you might need out to six weeks. So somebody who can’t get like, duties and is stacking shelves in a supermarket they’re gonna end up taking close to a month.
Trish
Yep. Got it. Got it. Wonderful. Look, I’ve got to say thank you so much for the time to speak with me today because I really appreciate taking time out of not just to be these people, but we’re at the weekend. You should be relaxing.
Dr Talbot
Don’t answer that.
Trish
Well, thank you so much for joining us. Look, if you do wanna get in touch Dr. Talbot, as I said, the website uppergisurgery.com.au. I’ll put it all on the blog post for this as well. So thank you so much for joining me.
Dr Talbot
Thanks, Trish. Have a good weekend.
