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Global Patient Services Spring 2012

Patient Experience

Bolivian Teen Can Enjoy Her Favorite Activities Again After Successful Surgery on Both Knees

Yasna Lucia Perez on her horse in Cochabamba, Bolivia, in June 2011. The Cleveland Clinic knee surgery patient has been riding horses since she was 7 years old and has placed in the National Horse Competition five times.

When Biserka Vranicic de Perez and her husband Federico found out their then 6-year-old daughter Yasna Lucia eventually would need surgery on her knees, they decided to wait until she was older. She was still able to walk, do ballet and ride horses despite the discoid lateral menisci in both knees.

“She was so little, we decided to wait,” Mrs. Perez says.

So when Yasna Lucia was 13 and began having pain in her knees and difficulty doing some of her favorite activities, they knew the time had come. Mr. and Mrs. Perez already had decided they would have the surgery done outside of their native Bolivia. They decided to look into Cleveland Clinic, where Mr. Perez’s father had gone for hip surgery a few months prior and had a good experience. Online research and conversations with doctors in Bolivia confirmed for them it was the right choice.

“My daughter had great confidence in the doctors at Cleveland Clinic,” Mrs. Perez says.

Yasna Lucia Perez in the United States in December 2011, two months after her first knee surgery.

In October 2011, Paul Saluan, MD, of Cleveland Clinic’s Orthopaedic Surgery Department, performed the first of two surgeries to repair Yasna Lucia’s knees. Her recovery was so fast, the Perez family decided to have the second one done just a few months later, in January of this year.

“We were really impressed with Cleveland Clinic,” Mrs. Perez says. “Everyone was very professional and respectful.”

She is grateful to the medical staff and the staff of Global Patient Services (GPS). Maria Elena Jablonski, a GPS Patient Service Specialist, assisted the Perez family on their trips to Cleveland for both of Yasna Lucia’s surgeries. She helped them navigate the hospital, provided a personal itinerary for appointments, and provided interpretation and other services to add to the family’s comfort during their stay.

“They all had so much patience with us,” Mrs. Perez says. “I think I made some friendships with the Global Patient Services staff.”

Yasna Lucia and her family are back in Bolivia where she is recovering well and undergoing rehabilitation therapy.

“The doctors said Yasna Lucia will be able to go back to doing everything she needs to,” Mrs. Perez says. “We are really grateful and want to thank all of the people at Cleveland Clinic who helped us.”

Spotlight On…

Losing Weight and Gaining Health: Cleveland Clinic Helps Thousands of Patients Through Bariatric Surgery

Scientific evidence shows that excess body weight leads to many health problems. In fact, if you have been severely overweight for between 10 and 30 years, you are twice as likely to die earlier than someone of average weight. Some of the life-threatening conditions associated with obesity include hypertension, heart disease, diabetes, obstructive sleep apnea, stroke, acid reflux disease and cancer.

Bariatric surgery is an effective tool for shedding significant weight, which in turn may have beneficial effects on many of the conditions associated with obesity. And for some, surgery can yield more effective results than weight loss achieved through diet and exercise because it results in more dramatic weight loss.

Surgical weight management is typically performed for those who are 100 pounds or more overweight, as well as those with a body mass index (BMI) of 35 or higher and who have one or more obesity-associated conditions, such as type 2 diabetes. Additionally, bariatric surgery may be recommended for those who have a strong family history of obesity and/or have tried many times, unsuccessfully, to lose weight by non-surgical methods.

There are several bariatric procedures, all of which help people lose weight in slightly different ways. The Roux-en-Y gastric bypass is the most commonly performed weight loss operation. It works by making the stomach smaller, which restricts food intake, and alters the path of digestion by bypassing a segment of the small intestine. In the majority of patients, a Cleveland Clinic bariatric surgeon can perform the gastric bypass procedure using minimally invasive surgical techniques, allowing for smaller incisions, fewer complications and a quicker recovery. A second commonly performed bariatric procedure is gastric banding. This is a restrictive operation, which involves placing an adjustable band around the upper part of the stomach, making the stomach smaller and thereby restricting the amount of food that can be eaten. A third procedure used for select patients who are not candidates for the band or gastric bypass due to severe medical conditions is the sleeve gastrectomy. This procedure includes removing about 75% of the stomach, leaving a narrow gastric tube or “sleeve” through which food passes.

Most Cleveland Clinic bariatric surgery patients lose between 50 to 80 percent of their excess body weight during the 18 to 24 months following surgery. Quality of life improvements have been found in 95 percent of patients and long-term mortality from obesity-related disease is reduced by 30 to 40 percent. Research also showed that more than 90 percent of Type II diabetics obtain excellent results, usually within a few weeks after surgery: normal blood sugar levels, normal Hemoglobin A1C values, and freedom from all their medications including insulin injections. Based on numerous studies of diabetes and its complications, it is known that the problems associated with diabetes slow in their progression when blood sugar is maintained at normal levels. Some physicians have suggested that surgery may be the best treatment for diabetes in the seriously obese patient.

For patients who choose not to undergo surgery, or for those who are ineligible, Cleveland Clinic’s Bariatric and Metabolic Institute also offers medical management for weight loss. Dietitians, psychologists and exercise physiologists work together to assist patients in identifying and managing the issues related to their obesity. Some medications, such as appetite suppressants, can be prescribed to aid in weight loss.

Patients come to the Cleveland Clinic Bariatric and Metabolic Institute from across the country and around the world because of our excellent outcomes. The Cleveland Clinic Bariatric and Metabolic Institute have been named a Bariatric Surgery Center of Excellence by the American Society for Bariatric Surgery and the Surgical Review Corporation. The designation is awarded to programs with a proven record of favorable outcomes for weight-loss surgery. Our skilled, experienced surgeons have performed thousands of bariatric procedures. More than 95 percent of our bariatric surgeries are performed with a minimally invasive approach, meaning shorter hospital stays and faster recovery.

Spend Some Time Enjoying Cleveland

Though your top priority is your loved one with whom you traveled for medical care to Cleveland Clinic, you most likely will have some free time during your stay. The city of Cleveland offers a wide variety of entertainment venues, restaurants, shopping and cultural activities to enjoy.

Museums and Cultural Activities

Cleveland Clinic’s main campus is located three miles east of downtown Cleveland, near University Circle, the city’s largest cultural center. University Circle offers a large concentration of museums and cultural activities including:

Cleveland Museum of Art – Internationally renowned for its Asian and Egyptian art and for its tens of thousands of international artworks in its permanent collection.

Cleveland Botanical Garden – Twenty specialty indoor and outdoor gardens welcome the public and provide education and tranquility.

Cleveland Museum of Natural History – Permanent exhibits showcase such things as a 3-million-year-old hominid skeleton, while the museum features a planetarium, observatory, discovery center, live animal shows and a wildlife center and woods garden.

Severance Hall – Considered one of the world’s most beautiful concert halls, Severance Hall serves as the home of the world-renowned Cleveland Orchestra.

Rock and Roll Hall of Fame and Museum – Further west of University Circle, on the outskirts of downtown Cleveland, the Rock and Roll Hall of Fame and Museum houses a world-class collection of exhibits showcasing the history and continued significance of rock and roll music.

Playhouse Square – The nation's second-largest performing arts complex features several beautiful theaters.

Shopping and Dining

Several interesting and unique neighborhoods are situated near Cleveland Clinic’s main campus. Little Italy features a charming collection of intimate Italian restaurants, antique shops, art galleries and boutiques. Shaker Square is the picturesque gateway to Cleveland’s beautiful and historic suburb of Shaker Heights. The square features fine restaurants and unique shops. Also worth exploring are Cleveland’s Cedar-Fairmount District and Coventry Village, both close to Cleveland Clinic’s main campus and both offering unique dining, shopping and entertainment experiences.

Upscale shopping venues can be found in Beachwood, Ohio, a short drive from Cleveland Clinic’s main campus. For an upscale mall experience, Beachwood Place offers department stores, chain and specialty retailers. Legacy Village offers popular retail stores and dining in an outdoor village atmosphere, and Eton Chagrin Boulevard offers boutique and specialty store shopping and restaurants.

Outdoor Activities and Professional Sports

Lake Erie provides entertainment for sailing enthusiasts, boaters, swimmers and fishermen. The Cleveland Metroparks’ 16 nature reserves encircling the city, along with the Cuyahoga Valley National Park, offer running, hiking and biking trails and many outdoor activities. Winter in Cleveland unveils cross-country and downhill skiing, tobogganing and snowmobiling. Major league sports are represented by the Cleveland Browns, Cleveland Indians and Cleveland Cavaliers.

For more on what to do in Cleveland during your stay, visit, or

New Cleveland Clinic Partnership to Provide Streamlined Access for Patients in Saudi Arabia

To better serve patients from Saudi Arabia, Cleveland Clinic recently affiliated with Healthcare Development Holding Co. (HDH), a leading Saudi Arabian firm dedicated to enhancing the quality and infrastructure of healthcare services in the region.

Through the partnership, called Cleveland Clinic Global Solutions, a new office opened in Riyadh, Saudi Arabia, in January to provide streamlined, expanded access to Cleveland Clinic for patients in Saudi Arabia who may need medical second opinions or appointments with Cleveland Clinic physicians in the United States.

Safwat Al Zuraiki, Managing Director of the Middle East for Cleveland Clinic, says the new partnership will provide “two-way learning opportunities for Saudi Arabia healthcare institutions, their physicians and Cleveland Clinic. It also will offer a local platform for patients needing medical second opinions and/or treatment to access services at Cleveland Clinic.”

Cleveland Clinic and HDH will collaborate on education and training for physicians, share medical knowledge and cultivate professional relationships among members of each healthcare community.

Chat With Us – Online Health Questions, Answered

Web chats and transcripts give you 24/7 access to health information

Wish a Cleveland Clinic physician could stop in at your home to answer your health questions and concerns? With our web chats and transcripts, the health information you’re looking for is just a click away and you can access it any time of day. Connect and participate in our live forums featuring Cleveland Clinic physicians and health educators. Or, read transcripts at your convenience. These make getting answers easy no matter your time zone.

Participate in a live chat: Visit our web chat homepage and create a user name and password. Your user name will be visible if you post questions during the chat, so be sure not to choose your real name or email address.

Ask questions: To submit a question during a web chat, type into the text box below the chat display and press enter. Or, click the ask button. Physicians will answer as many questions as possible during the chat.

Read transcripts: Click on the transcript tab at the top of the web chat page and you will find links to heart and vascular and general health information transcripts.

Access a variety of topics: Whether you want to know more about abnormal heart rhythm or you want to find out more about a prescription medication, there are dozens of topics available in the transcripts section of the site. Upcoming chats are listed on the main web chat page.

Find more information: After viewing a web chat or transcript, you may decide to contact Cleveland Clinic. On the web chat page, you can easily access the online Cleveland Clinic phone directory or request a second opinion.

Get started: Visit us online or call 800.223.2273 if you have questions.

Recipe Corner

From the latest issue of Children's Health Essentials eNews

Meatless Chili

The American Institute of Cancer Research recommends limiting red meat to no more than 18 ounces per week. Consuming more may increase colon cancer risk. Use a meat substitute, such as soy, to enjoy your favorite recipes without the guilt. In a flavorful dish such as this chili, you can’t tell the difference. Soy also is rich in fiber and may provide heart benefits.