UC Davis Health Bariatric Surgery Team
February 2023
UC Davis Health
Bariatric Surgery Team
UC Davis Medical Center
Sacramento
,
CA
United States
Judy Tsurutani, MSN, RN, PHN, CBN
Angela Salas, RD, CSOWM
Randi J McCreary, RD, CNSC
Raquel Russell, RD, CDCES
Emmanuel Zamora, Psy.D.
Barbara Jachniewicz, DNP, FNP-BC, CRNFA
Kendra Look, DNP, APRN, FNP-C, CBN
Janice Hicks
Diana Saelee, MS, RN, NEA-BC, MedSurg-BC
Dr. Mohamed Ali
Dr. Hazem Shamseddeen
Dr. Victoria Lyo
Dr. Shushmita Ahmed

 

 

 

Judy Tsurutani is the Nurse Coordinator for the Bariatric Surgery Program. She leads a multidisciplinary team consisting of three dietitians, a psychologist, a medical assistant, two nurse practitioners and several surgeons. She has passionately led this team for over two decades, going above and beyond daily to provide excellent care to this medically and socially complex patient population. Though every member of the team is essential in providing patients with the highest level of evidence-based care and respect, it takes an anchor—a Judy—to bring together the various team members’ expertise to synergistically care for patients with medically complicated obesity. 

In 2018, T, a 31-year-old male, started his journey with the Bariatric Surgery Program. His medical history involved many comorbidities, including severe sleep apnea, venous statis, depression, overeating, binge eating, hypertension, and an initial start weight of 664lbs. At his consultation with the bariatric team, T met the providers that would eventually change his life. The surgeons evaluated T’s medical history and established the plan of care.  Judy then went on to review this plan of care with T, providing the reasoning behind the elongated list of tests needed prior to surgery. Since T lives beyond the Sacramento area, Judy communicated with the medical assistant to provide necessary out-of-town accommodations, extra time to coordinate appointments with providers closer to home, and established a plan for regular follow up to gather medical testing results as he was able to complete workup items. 

It should be noted that the routine weight loss requirement for most patients before qualifying for bariatric surgery is approximately 10% of their starting weight. This assures safe recovery and easier surgical access. However, at T’s starting BMI of 92.74kg/m2, he was required to lose over 100 lbs. before being considered a surgical candidate. 

With the significant weight loss undertaking in front of him, T began working with the dietitian group monthly. He first attended nutrition classes to provide education on how best to nourish his body both pre- and postoperatively while also achieving healthy weight loss in the process. He then went on to meet regularly for individualized goal-setting with the RD group over a four-year timespan. His pre-op care was implemented by meeting with psychologist, Dr. Zamora, who recommended cognitive behavioral changes, and providing support, trust, and integrity during ongoing follow-up visits. 

However, along his journey, T was thrown some major hurdles that made getting to surgery even more challenging. One of these challenges included overcoming social isolation at the height of the pandemic. T remained vigilant and committed to the process by scheduling regular video visits to ensure he stayed on the right track. Later in his pre-op journey, T also faced a traumatic injury that involved falling through a deck. This was an event that almost cost him his life, and required multiple hospitalizations that made him well-known within the trauma service as well. With these hurdles thrown in T’s path, Judy, the dietitians, and Dr. Zamora, all showed extraordinary love and compassion to T by keeping him motivated amid these setbacks. As demonstrated in T’s case, each member of the bariatric team served as a piece of a complete puzzle that yielded extraordinary love, compassion, courage, and integrity to see him through some of the most trying times of his life. 

Years into his journey, Tu lost close to 90lbs. from his start weight via implementation of the science-based, compassionate, individualized recommendations provided by his bariatric care team. Still, he still had more weight to lose, further complicated by fluid shifts resulting in robust weight fluctuations confounding his true weight loss efforts. He resultantly required cardiac clearance as an added layer of complexity before he could be considered for surgery. Yet, at his size, testing for this clearance was not possible, and notably discouraging for T. Recognizing T’s disappointment, Judy collaborated closely with cardiology to find a solution for cardiac clearance that worked within his physical limitations. She further coordinated a plan to have cardiac services on standby on the day of surgery. 

T finally received his surgery date in August of 2022 after a four-year pre-op journey. As soon as Judy was given the green light from the attending surgeon, Dr. Ali, she worked late after a very busy clinic day to ensure T’s dietitian could be present when providing this excellent news. When T received this information, he told Judy, in tears, “I have been waiting all my life for this opportunity, and now it’s becoming my reality.”

T has since had a successful surgery, losing over 210lbs. since his procedure. His life has changed, and in November 2022, he walked his first 5K. The bariatric team continues to support Tucker’s successes through regular medical and nutrition follow-ups, monthly support group offerings, and coordinated community events. He has walked two community 5Ks with the bariatric team in 2023, and in his most recent October race, he ran the last 100 yards. He has even gone so far as to coordinate several 5K races in his own hometown and is an inspiration to many future and post-surgery patients.  

After years of the team supporting, encouraging, and caring for T, he was able to persist and is now a name well-known across multiple services in the UC Davis hospital system. He has been so invigorated by his transformative journey that he is in the process of writing a book to encourage others through sharing his story. He will be the first to note that his bariatric care team was integral to his life change, and recognizes the compassion, extraordinary love, courage, and integrity spearheaded by nurse Judy and her team.