by Jill Clendening
In May 2020, dangerously high blood pressure put 44-year-old Kristian Wernet in the hospital, a tipping point that led him to become one of the first individuals to have gastric bypass surgery at Vanderbilt Wilson County Hospital (VWCH) as a patient of the new Vanderbilt Weight Loss Center in Lebanon, Tennessee.
Christopher Menzel, MD, an assistant professor of Clinical Surgery at Vanderbilt University Medical Center, opened the community-based center in October 2020. Menzel is the medical director of Bariatric and Metabolic Surgery at VWCH, where he now performs bariatric surgeries including laparoscopic gastric bypass and vertical sleeve gastrectomy. He also performs revisional surgeries, such as removing gastric bands and converting previous sleeves to gastric bypasses.
This expands on the surgical weight loss surgeries that have been offered to patients in the Wilson County area by surgeon Nancy Barrett, MD, who performs gastric band and gastric sleeve procedures at VWCH.
Menzel is fellowship trained in bariatric and minimally invasive surgery, and the new program in Lebanon mirrors the longstanding Surgical Weight Loss Center at Vanderbilt Health One Hundred Oaks in Nashville. VUMC’s Surgical Weight Loss program is widely regarded as a premier bariatric center and consistently ranks in the top percentiles in the country in successful outcomes and low rates of complications after bariatric surgery, specifically gastric bypass.
“I’ve always had trouble with my weight,” said Wernet, who is a Williamson County Sheriff’s Office school resource officer. “It’s mostly genetics; both of my parents are a little heavy. I weighed 256 pounds, and I’m five foot four. I was making my heart work way too hard.”
“We commonly see people after they’ve tried other weight loss methods — dieting, fitness and medications — without success, and they’re often at their wit’s end,” said Menzel. “They’re dealing with medical and psychosocial issues including diabetes, hypertension, depression, joint pain, sleep apnea and other weight-related complications. Following bariatric surgery, we see substantial remission rates of all of these comorbidities. I emphasize these points to anyone struggling with weight; it’s about weight loss, but even more so it’s about improving their health and preventing other health problems.”
In addition to lowering his blood pressure, Wernet wanted to be healthier for his wife, Ashlea, and his three active children. For years he had tried dieting, and walking the hallways and grounds at Brentwood High School during work already had him logging over 10,000 steps daily. For him, diet and exercise weren’t the answer.
He was thrilled to learn the Wilson County practice was open, was just 35 minutes from his home, and kept him out of Nashville traffic. When he had his first appointment with Menzel in November 2020 he was also impressed with the clinic’s hometown feeling and friendliness of its staff.
Three days a week, Menzel meets patients at 1616 West Main Street in Lebanon for initial consultations and pre- and post-operative visits. Crystal Hawkins, APRN, a longtime practitioner at the Vanderbilt Health One Hundred Oaks center, as well as dietitians, also see patients there. Individuals are also evaluated by a psychologist and participate in a support group. Because of the pandemic, pre- and post-surgery patients gather online in a private support group rather than in person. Though patients currently travel into Nashville to see a psychologist, there are plans to add a psychologist at the Lebanon clinic soon.
Wernet admits the idea of bariatric surgery made him nervous, but as he worked through a pre-surgery checklist and met with each health care team member, he soon felt well prepared and supported. His primary care physician was also impressed to receive regular progress updates from Menzel and his team, leading up to and following his March 2 surgery.
“Our preoperative program is one of the reasons why our patients do so well,” said Menzel. “They learn what’s important to optimize their success, and these fundamentals are ingrained by the time they get to surgery. Regular post-surgery office visits are vital, too. We want our patients to feel like family; if there’s any concern whatsoever, I want to know about it.”
Another key component of the program is the Enhanced Recovery After Surgery (ERAS) protocol Menzel follows. This includes nerve blocks placed before surgery to numb the abdominal wall, non-narcotic medications such as acetaminophen and gabapentin to decrease post-operative pain and walking frequently soon after surgery. Modeled after the ERAS protocol developed at VUMC, the implementation of the practice at VWCH significantly reduces the use of opioids for pain control, enables quicker recovery and leads to superior outcomes.
As for Wernet, by mid-March his weight was already down to 223, his primary care physician reduced his blood pressure medication by half, and his family and friends have been celebrating his progress.
“I’d do this again in a heartbeat; this has given me a new lease on life,” he said.