Obesity threatened her daughter’s health, so a grateful mother turned to the Children’s Hospital for help

Scott Scanlon Buffalo News

Ava Brandeis’ weight problems started when she was an infant when she started gaining three pounds per month on a typical diet schedule.

Panicked, her pediatrician ordered a battery of tests starting at 9 months old. As Ava grew, results continued to show that key health indicators were normal.

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“The years went by and we took a break from everything because we didn’t get answers,” said her mother, Kristi Paradowski.

Ava, who was 13, weighed 330 pounds by last school year, when doctors discovered she had high blood pressure, prediabetes and sleep apnea. They prescribed a continuous positive airway pressure (CPAP) device to help her breathe better at night.

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“Our biggest concern was what would happen to her blood pressure,” her mother said. “Are you going to have a stroke? Are you going to have a heart attack?”

Pediatrician referred Ava to the Healthy Weight Program at John R. O’Shea Children’s Hospital in Buffalo. As a result, this month she started her freshman year at Lancaster High School 100 pounds lighter – and a lot happier.

“I came here, I just wanted answers,” she said.

before surgery

Ava Brandeis, of Lancaster, poses for a photo last November with her mother, Kristi Baradowski, from a trip to Disney World before having bariatric surgery in February.

Libby Marsh, Buffalo News

Dr. Carol McHarmon, Chief, Department of Pediatric Surgery, UB Jacobs College of Medicine and Biomedical Sciences

One reason why bariatric surgery on teens has been controversial for more than a decade has been because of the definition of an adolescent: “an incompatible person,” says Dr. Carol “Mack” Harmon, chief of pediatric surgery at the University at Buffalo School of Medicine and chief medical officer with healthy weight program

Photo courtesy of the University at Buffalo

The Healthy Weight Clinic is located in the Conventus Medical Office building, along with Oshi Children’s. It opened December 30, 2014. The first child patient, in their mid-teens, weighed 550 pounds.

Since then, staff have treated patients as young as 2 years old, not only for excess weight but also related health conditions.

“We only work on teens with complications of obesity, so we tell them, ‘We treat your high blood pressure, we fix your sleep apnea. “Oh, and by the way, you’ll lose weight, too,” said Dr. Carol “Mack” Harmon, director of the surgery program.

Sarah Alexander, a registered nurse and registered dietitian who helps drive a healthy weight, said the clinic sees children of many backgrounds from across the region, as well as northwestern Pennsylvania.

The staff also includes a pediatric nurse practitioner, psychologist, social worker, endocrinologist, occupational therapist and physical therapist – focusing on body composition, not weight.

Simplified help parents and children, Organized meal planning with real and whole foods. Regular exercise is emphasized, along with personal attention to good sleep, mood, habits, and coping strategies.

Bariatric surgery is offered as part of the program, but only about 10% of patients get it, said Harmon, who is also chief of surgery at Kaleida Health and the university’s department of pediatric surgery at Buffalo Jacobs College of Medicine and Biomedical Sciences.

Behavior change, surgery or not, is emphasized.

The pediatric surgeon said that during the first meeting with program staff, parents typically say their children’s blood pressure and blood sugar alarm them the most. “The teen often says, ‘I don’t like my clothing choices, I can’t keep up with my friends, I get tired before they get tired. “

Treatment plans fall into place over time. The program, which takes out health insurance, requires those interested in surgery to spend six months in treatment before being considered. Team members help determine whether patients and their families would benefit – and commit to maintaining a healthy weight.

Most Harmon Pediatric Surgical Days involve repairing a hernia, removing the appendix and gallbladder, and helping with trauma and birth defects. He performs one or two bariatric surgeries per month.

“We have two buckets of patients,” he said. “They are here because they want to learn how to eat properly and exercise better. Some of them have a genetic predisposition to obesity. Of all the patients we see, only very few are interested in surgery or that we find would be a good candidate.”

Ava Brandeis Workout

Ava Brandeis, 14, works out three times a week in the gym at her apartment complex in Lancaster. A typical exercise program includes a 6-minute warm-up exercise on a treadmill, followed by strength training.

Libby Marsh, Buffalo News

One of the reasons teens had the surgery initially controversial was the definition of a teen: “a non-conformist,” Harmon said.

“There are a lot of lifestyle changes that have to happen after surgery,” Alexander said. “We need to know that they are dedicated and able to last for a long period of time, so in addition to getting to know us all, it is important for us to know that they can commit to these changes over the long term to ensure success.”

The Healthy Weigh team is committed to these young patients as well by insisting that patients continue to stay connected as they move into their 20s and 30s.

In the early years, the clinic often saw overweight teenagers. Not anymore.

“We have had success with children under five,” Alexander said. “When you come to us, we can help families make changes that are long lasting and prevent children from having these issues as they get older.”

almost all obesity It’s a combination of genetics and environment, Harmon said. Most obesity, he said, is closely related to learned behaviors at home, school, and society, “but we all know the people to whom we say, ‘How can you eat that much all the time and be so thin?'” “”

Less than 6% of people have a single genetic mutation that inactivates leptin, the hormone that tells the body to be full while eating. Through the clinic, Ava Brandeis, now 14, learned that she had two genetic mutations that play a role in her eating habits, although their strengths are somewhat less clear.

Her mother has taken her to five nutritionists over the years who have put her on a variety of eating plans, including the 900-calorie-a-day diet. Before kindergarten, all sweets, including chocolate and birthday cake, were off limits.

As she gained weight, interactions with her peers during elementary and middle school became less frequent.

“People will notice I was there, but they won’t try to interact,” she said.

Ava and Kristi

Kristi Paradowski, right, says of her youngest daughter, Ava Brandeis, 14, who lost 100 people with help from the O’Shea Children’s Health Weight Program.

Libby Marsh, Buffalo News

Things started to change when I started the “Healthy Weight” regimen last fall. She had lost 25 pounds by the time it became clear that with a genetic predisposition to gastric sleeve surgery was an option she could take. The deliberations often speak with teens and parents who have had the procedure at Oishei Children’s.

“I had to prepare myself more psychologically, but I knew I wanted to,” she said.

She underwent surgery on February 22. I’ve lost 75 pounds since then. She continues to visit the Healthy Weigh team once a month to inform the treatment team about her dietary and activity options and to ensure that surgical risks including GERD and abdominal pain are not bothersome.

They didn’t – she’s off her CPAP machine and her diabetes medicine. Today, she said, salad, chicken and two protein shakes are staples in her diet. Three workouts in the gym in the apartment complex where she lives with her mother also set a healthier tone.

“It’s not just about weight, it’s blood pressure, blood sugar, blood lipids, liver function and sleep apnea,” Harmon told her during a visit to a healthy weight clinic last week. “From the surgeon’s point of view, I am really happy with the way you did. We want you to keep working, and that means keep coming back.”

Ava said success and good advice prompted her to do so.

“I have more energy. I am able to do more activities and exercise. I feel like this has helped me prepare. It has been a huge relief, to know something can be done.”

This past spring, she made the National Junior Honor Society and joined the Lancaster Prep School Student Council. She hopes to achieve more academic success and do more activities in her first year at Lancaster High School.

“You can tell she wanted it just by the results she was able to get in six months,” her mother said. “She is so happy, and I am so happy to see her smile.”

Learn more about the Healthy Weight Program with your child’s pediatrician at OCHBuffalo.org/care-treatment/healthy-weigh or By calling 716-323-2000.

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