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Janet S A New Lease on Life

After weight loss and hip replacement surgeries, Janet's health was transformed.

Janet Scratchley, 57, struggled with her weight her entire life. “I’ve gained and lost weight many times, and I thought that was never going to change,” she says. For nearly a decade, the elementary school teacher in West Long Branch lived with worsening back pain. “I tried everything—physical therapy, aquatic therapy, anti-inflammatory medications, epidural injections, a back brace and acupuncture,” she says. “I would feel better for a little while, and then my symptoms would worsen.”

Eventually, the pain became so debilitating that Janet stopped taking her dog, Chelsea, a golden retriever mix, to the beach, and did little more than go to work and come home. “I went to a store twice in two years and out to dinner maybe two times,” she says. Meanwhile, Janet’s weight crept upwards, which only made matters worse. The school eventually got her a motorized scooter to get around at work.

The Turning Point

Janet saw around eight physicians for the back pain. Finally, she discovered that her pain wasn’t coming from her back but from her hip. “I had osteoarthritis in my hip, in which the cartilage that cushions a joint breaks down,” she says. She needed hip replacement surgery to relieve the pain.

Unfortunately, Janet wasn’t eligible for the surgery because her body mass index (BMI), a height-weight ratio that can signal a person’s risk for health problems, was 53. Studies show that when a person’s BMI is above 40, the risk for complications from surgery, such as infection, rises significantly. In addition, postoperative rehabilitation can be difficult for these patients. Janet also had diabetes, which interferes with healing. “I thought, ‘I’m just going to wait to die now,’” she says.

Luckily, a friend suggested that Janet see Ragui Sadek, MD, Medical Director of Bariatric Surgery at Robert Wood Johnson University Hospital (RWJUH), who takes a team approach to managing complex cases like hers. He explained that she could drop excess pounds through a procedure called sleeve gastrectomy. The surgery involves making several small incisions in the abdomen and placing small instruments and a tiny camera through those incisions. The surgeon then creates a small, sleeve-shaped stomach about the size of a banana, which helps patients consume less food and can lead to significant weight loss. “The majority of patients lose 75 to 80 percent of their body weight,” says Dr. Sadek. Sleeve gastrectomy also reduces levels of hormones that contribute to hunger, decreasing appetite.

Janet had the surgery in August 2018 and did well. “We were able to help her lose a significant amount of weight, cure her diabetes, resolve her sleep apnea, and prepare her for joint replacement surgery,” says Dr. Sadek.

Janet wanted to see an orthopedist affiliated with RWJBarnabas Health, so she made an appointment with David Harwood, MD, an orthopedic surgeon at RWJUH and Clinical Associate Professor of Orthopedic Surgery at Rutgers Robert Wood Johnson Medical School. “I often see patients like Janet who are in tears because they are in extreme pain and have been told by multiple people that they are not surgical candidates and there is no hope,” says Dr. Harwood.

When Janet saw Dr. Harwood in September 2018, she hadn’t lost enough weight to qualify for hip replacement surgery. By January, however, she had dropped an additional 50 pounds and was able to have the surgery. “Some people think bariatric surgery is a drastic way to lose weight, but for some patients it’s the only way forward,” says Dr. Harwood. “It’s safe, and it helps patients improve their mobility.”

The Road to Recovery

Janet has been in physical therapy since January—not only to adjust to her hip implant, but also to recondition her body. “People need to recover not just from the surgery but also from the months or even years of disuse and atrophy of their muscles,” says Dr. Harwood.

Janet, who has now shed more than 100 pounds, has already noticed a dramatic difference in her lifestyle. She uses a treadmill at physical therapy, is getting out more, and even takes Chelsea on walks. “Between the two surgeries, people are literally metamorphosed,” says Dr. Harwood. “They go from being wheelchair-bound to functioning normally. I fully anticipate that Janet will be back to a normal life.”

“My life after my surgeries is like night and day,” says Janet. “These procedures have made it possible for me to do the work to lose the weight. My experience at RWJUH has been nothing but positive and supportive. I tell Chelsea, ‘Hang in there. We’ll go to the beach soon.’”

A Symbol of High-Quality Care

Robert Wood Johnson University Hospital (RWJUH) recently earned The Joint Commission’s Gold Seal of Approval for its Hip and Knee Joint Replacement Programs and its Bariatric Surgery Program. To achieve this certification, RWJUH underwent a rigorous on-site review in the fall of 2018. The Gold Seal of Approval is awarded for complying with national standards of care.

“Our program went through some of the most vigorous testing and evaluation to make sure that it’s at the highest level of safety, efficiency and outcomes,” says Ragui Sadek, MD, Medical Director of Bariatric Surgery at RWJUH. “We meet all standards and are actually above the national average for most of these standards.”

To learn more about bariatric surgery at RWJUH, visit www.rwjbh.org/rwjuhbariatric. To learn more about orthopedic surgery at RWJUH, visit www.rwjbh.org/rwjuhortho.