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Not All Balloons Are Created Equal, Says Bariatric Nurse Casey Quinn.


Not All Balloons Are Created Equal, Says Bariatric Nurse Casey Quinn.

Felicity Cohen: Hello, I’m Felicity Cohen. I’m so excited to introduce you to my wellness warriors podcast. For over 20 years, I’ve been a passionate advocate for helping thousands of Australians find solutions to treating obesity and health-related complications through surgical intervention and holistic managed care.

My podcast is dedicated to all the people. Past, present and future who have helped shape my journey and continue to inspire me to work consistently to achieve a healthier Australia in both adults and future generations. I hope you enjoy it.

Welcome to my wellness warriors podcast today. I’m very excited because it’s not often that I get the opportunity to speak to one of the team members from weight loss solutions Australia. And today we have Casey Quinn here with us. She’s one of our bariatric nurses and incredibly talented, experienced in the area of bariatric nursing and looking after all of our patients and right from the start of their journeys, which is a really unique role and opportunity to work with patients, right from the beginning, all the way through their journeys.

Can I just start by asking, what is it that you enjoy most about working with a bariatric patient population?

Casey Quinn: I love working with our patients because I see their lives change so dramatically for the better. And it’s addictive. It’s amazing. And being able to be part of that journey is a privilege for me.

So having that chance to really see people’s lives, improve both medically, physically, emotionally hearing their stories and connecting with them as people and as individuals is just, I can’t imagine any more of a satisfying job really. The connection. Yeah. The medical scientific, amazing outcomes for them is amazing.

Felicity Cohen: I think that’s one of the things that’s most rewarding is watching the change in medical co-morbid conditions over time and not just resolution, cause they’re not always able to cure everything. It might just be reduction in medication or changing how they feel. But the long-term outcomes in terms of prevention is a really powerful thing that we’re able to achieve.

Bariatric intervention and really good lifestyle modification. And, you know, we use it as part of our team is so, so critical because that connection with an allied health team to impact change, that’s where it comes from. And I think it’s important to make that point that surgery or intervention is just a piece of the puzzle that all these other components, which is really just an incredible allied health.

Are the magic in terms of that personal relationship that you have with your patients to work over time. Because what we know about lifestyle modification, which I think is super interesting is that statistically, if you’re working with a patient for 12 months and you’ve got that opportunity, we know that at 12 months you can hopefully help them to not just create new habits, but that those habits will then become habits for life.

So that’s why that 12 months is such an important time span.

Casey Quinn: It really is. The 12 months is so important because there’s so much that can change in that time, irrespective of the intervention that people have had to help manage their weight. And also a lot of the old emotions around fear of failure and sabotage and all those sorts of things can come out and having a really supportive team there that really gets it and really understands what people are going through.

Can take people and steer them back on track. Cause it can just take a moment. It can just take a moment for things to go off course. And when you know, you’ve got an amazing team behind you and you can just pick up the phone, it really, you know, gets things going back the way they kind of need to be for the long-term success beyond the 12 months.

Felicity Cohen: Absolutely. And I think sometimes it can just take one person to reach out and to connect at the right time to make the most amazing change and difference in someone. Yeah. Absolutely.

And you’re doing that every day.

Thank you today.

We’re actually going to talk about the balloon devices specifically. And one of the reasons I really wanted to talk about balloons is because not all balloons are created equal. We’ve got so many on the market now. and it’s a great time for us to look at how they all behave, what they all do. essentially once they’re inserted, they all behave, behave the same way, but would you like to start by walking us through?

Maybe we can start with, the Orbera because it’s the one we’ve had on a hat around for a long time and, in weight-loss solutions Australia with them. This particular device since 2007. Yeah. Yeah. A long time.

Casey Quinn: It’s a really long time. So, this is an example of the Orbera balloon, but really this sort of diagram that you can, you can see here.


it has to describe it a little bit for those who are just listening to us on the podcast and not those you can see.

Well, so, so basically, the, the concept of the balloon is that you put a device in that takes up a large volume of space within the stomach. So you feel full off a smaller amount of food.

So the average adult stomach would expand to say a litre to 1.2 litres maximum. And with the balloon in that takes up about 500 to 600 mils. So you’re taking up roughly half of the stomach capacity so that when people eat a relatively small amount of food to what they’re normally used to eating the stretch receptors, particularly in the upper part of the stomach are triggered to say, Hey, I’m full I’ve had enough.

So it becomes more tolerable to go into a calorie deficit and lose weight as opposed to being ferociously hungry all the time in order to get, get the weight off. So the Orbera balloon is put in under sedation by a gastroscopy. So there’s no incision. about 15 to 30 minutes, roughly the procedure to put it in.

day-case so people need to be picked up afterwards, and it’s filled on the day and then kept in for either six or 12 months, depending on what the patient elects to do. And then it’s removed under anesthetic.

Felicity Cohen: So just to highlight, so we’ve got this device that looks a little bit like a breast implant, probably a really good way to describe what it looks like.

So if you can visualise. for those just listening to us. Yeah. It does look a bit like a breast implant. This round ball filled with fluid and it’s a space feeling capsule. So patients essentially just feel full. Yeah. so with that, with the Orbera balloon, I just wanted to mention the difference the six months and the 12 months, the 12 month is one that we have to print a special application for that’s.

Right. but that is available to patients and many people don’t actually know that that exists in those two device categories that we can still apply. 365, I think it’s called. And that is the one that we can have in for 12 months, which is great. Especially in patients who really feel that they need to lose more weight than, than they’re going to get from a six month device or they’d need that longer term opportunity.

Casey Quinn: Yeah, that’s right. It just gives you that little bit longer as well. Even if you’ve reached your goal weight or go weight loss in that period, say it’s six months. It can give you an extra six months to really solidify that and feel confident that you’ve maintained it before the balloon.

Felicity Cohen: So one of the other devices that we work with is the Spatz device.

Casey Quinn: Yep. Yep. I’ve got the Spatz device here. So the Spatz device, differs to the Obera balloon and the other balloon, which we’ll discuss soon called the, elipse balloon in that it can be adjusted. Once it’s in, for example, if somebody had the balloon put in and they felt quite nauseated, which is quite common in the early days, and they felt it became intolerable for them, they could go back under the anesthetic and have it adjusted.

And some of the fluid taken out which may alleviate the nausea, but it does, it’s a little bit finicky. It does require going in and accessing a port in there. alternatively, if people were. Perhaps get to the six month mark and they felt like they wanted to lose more weight than they needed more restriction.

You can also go in and refill it, and increase the volume.

Amazing. I mean, that’s just incredible technology. So it’s external valve that allows the endoscopist physician or surgeon, whoever is that right doing the procedure to go back in and inflate as the patient goes. And there’s no limit to the number of endoscopies in terms of to get that fill volume.

Right. but possibly for some patients, they might find that a little bit awkward because they’ve got to go back under anesthetic. Again, it means more time off work and others might see that as an advantage that you’ve got the potential to just feel as you need and get the weight loss that you wanting over a 12 month period.

Felicity Cohen: That’s okay. Yeah, they’re really interesting different device technologies and how they all function. And, the difference in, you know, who’s going to be right for what, and I guess that’s a conversation that patients would have with you around what their own personal circumstances are, how they behave.

Is it their behaviour a lot that drives you to help them make that decision around whether they need a six month or a 12 month, or how do you work that out?

Casey Quinn: So it’s their behaviour and also their history. For example, if we have, uh, individual use a woman postpart for example, it’s 12 months after having a baby prior to having babies, she was happy, healthy weight, and she’s got an carrying, an extra 15 kilograms that she just can’t get rid of.

Doesn’t want to go through the process of having an anesthetic. She’s just looking for sort of a more short term solution. She may be more inclined to go for the ellipse because, which we’ll discuss in a moment, the ellipse balloon, because it’s likely to get her that weight loss, but also that individual may not have had long-term weight problems.

There’s been an event that’s kind of triggered it. Whereas if I had an individual that perhaps has had, got a little bit more weight to lose, maybe more like 25 kilos and they’re looking, they really want to have that longer period of time of that sense of restriction. We may start to look more towards the Orbrea balloon or the Spatz balloon, because it’s going to be potentially for 12 months to give them more time to get the weight off. But also that period of time where they feel supported physically, that they’re still quite full before it’s removed really

Felicity Cohen: interesting. And our programs, we run for 12 months because we want to make sure that not only a patient’s going to get adequate weight loss during the timeframe in which they have the balloon inserted, but that we’re going to help them to maintain for the long-term those outcomes.

And I think one of the biggest fears that I hear people talk about. What about when the balloon comes out? So for example, if they’ve got it in for 16 weeks or six months, one of their first questions might be, well, am I going to rebound and put weight back on? Yeah. How do you respond to that?

Casey Quinn: Well, in the first instance, I tell them that’s a reasonable fear to have.

Because weight issues tend to come back. So there’s something we always need to be mindful of and thinking about. But also, many people who have these interventions performed, they’ve had a history where they have had successful weight loss on diets and it’s come back and it’s really disappointing.

So what I like to do is come up with a plan with them and go, okay, here’s our plan. This is just an example of a plan. the balloon comes out. We’re still that often still part of the program by the time the balloon comes out, we’re still continuing with the program. So they’re still working with us, but the door’s always open.

As you know, people can always come back and see us, but I’ll say let’s, let’s give it your best shot. You’ve done. You know, you will have done 12 months of amazing followup. You know, what you need to do around diet exercise. You’ll be working with a psychologist to work with emotional limits. So let’s look at it really positively.

That you’re going to do well, but we’ll, we’ll decide the patient and I on a ceiling. So we might say, okay, if you get to five kilos of weight, regain, give us a call and we’ll see what we can do, because we also have medical weight loss options that can help suppress the appetite reset, get that, you know, relatively small weight regained off with a medication.

Cause it’s doable with that sort of amount and then go from there. So I actually, with any patient, irrespective of what intervention they’re happening, having, I always like to talk about worst-case scenario, contingency planning, and it takes a lot of anxiety out of the situation for them.

Felicity Cohen:

Absolutely. And I think it’s fair to say that there is typically a little bit of recalibration.

So when the balloon comes out, it’s not unusual to gain a kilo or two. Absolutely. But if you’ve met your goal weight, and you also understand that you’ve got these new behaviour patterns, these new techniques and all this advice, advice, support, and, you know, education from a team. You’ve got to really be committed to the process.

So for me, when I look at something like a balloon, it’s a device, it’s a tool it’s part of what we can utilise to impact behaviour modification, but the relationship that you have with the team and your commitment, first of all, to yourself, you know. That relationship is super critical because there’s accountability.

You know, you’ve got to be, first of all, have that willingness, that drive and motivation, maintaining that we know is pretty difficult. And you’ve probably been down that path before, but if you’ve got this kind of accountability factor where you’ve got a team that you talking to, that you’re connecting with and, you know, You want this to be like no other diet has been before.

and you want to be able to get that weight off and maintain it that, you know yeah. Anything’s possible, but you, I guess a little bit of recalibrate is normal.

Casey Quinn: Yeah, it is. It is.

Felicity Cohen: I think, you know, setting up patients for realistic expectations, understanding the absolute ins and outs of, I think it’s great to mention worst case scenario because we need to go down that path and best case scenarios as well.

Cause that’s also incredible. One of my favorite balloon patients lost 22 kilos and got off her diabetes medication and stabilised at 20 kilos. Long-term like we’re talking a few years posts and kept off her diabetes medications. There’s some really phenomenal. Yeah. There’s some, that’s an out of the box. Amazing story. Yeah. But there are lots of those.

Casey Quinn: There are, and it’s important if somebody were to have a sleeve gastrectomy or a ruin, why gastric bypass or more sort of, you know, into permanent powerful, permanent procedure, they’re still going to have to up to four kilos weight regained from their lowest weight.

So like you said, it’s completely normal.

Felicity Cohen: Awesome.

Now the device and I am super excited about it. And I know that half the planet is also very excited about absolutely. We love new device technology because yeah, we get super excited when there’s new evolution in the world of bariatrics and that there’s new things to offer patients that come with so many benefits. So let’s start talking about the Elipse.

Casey Quinn: So this is what the Elipse balloon becomes.

Felicity Cohen: So it’s still a ball.

Casey Quinn: Yeah.

Felicity Cohen: It looks a bit like a breast implant. Yeah.

Casey Quinn: Roughly five to 600 mils. Wow. And this is how it starts. So basically what’s amazing about the ellipse is that there’s no sort of sedation, anesthetic, anything like that, that happens with it.

So it’s, you’re awake.

Felicity Cohen: Can we just talk about what it looks like? Because we’ve got listeners.

Casey Quinn: I’m sorry. That’s right.

Felicity Cohen: So it’s vegan.

Casey Quinn: Yeah, that’s important.

Felicity Cohen: And it’s a capsule so it’s something that you swallow. So one of the main things about the Elipse, is it you swallow it? Yeah. And is it right that there’s no endoscopy and no anesthetic?

Casey Quinn: That is correct. There’s no endoscopy, no anesthetic. So it’s a large capsule, essentially, that has tubing attached to it. The individual swallows it down basically. And then the positioning of the capsule is checked within the stomach to make sure it’s in the right spot. And then there is fluid inserted because the tubing is coming out of the patient’s mouth, which might sound pretty horrific, but it’s actually not that bad. People tolerate it well.

The fluid is inserted down the tubing, so that then once the balloon expands within the stomach and then the tubing is detached via sort of a trigger mechanism that pulls it out. So then the tubing comes back out of the mouth. Balloon is in, set in position and people can go home.

Felicity Cohen: It’s amazing. And there’s a second x-ray that’s performed once the balloon has actually been filled with the liquid, which is a proprietary liquid, it’s not just saline.

But it’s filled with this liquid and obviously then we have to perform, or the, the surgeon and the, the radiology department would perform a secondary x-ray before they actually detached that. Yep. Okay. Yeah. Is that right?

Casey Quinn: I think so. Yeah. That sounds about right.

Felicity Cohen: So there’s one I performed when the balloon is first positioned into the stomach and then post filling the device. That’s when they take a secondary x-ray just to make sure that everything’s a hundred percent fine before the patient gets up and walks out. I watched one video that showed a lady who literally had her Elipse device put in place and 10 minutes later, she got up left the hospital and went straight back to work.

Casey Quinn: Yeah, it’s amazing.

Felicity Cohen: It is amazing but I think also it’s important for us to focus on what the reality really does look like. That’s probably not going to be a common story.

Casey Quinn: Most people are going to feel quite nauseated after the balloon goes in and look, this applies to every intragastric balloon.

As you can imagine, when you have like a large foreign body sitting in your stomach for the first time, it can be a bit of a shock to the, to the gut lining and it could make you feel nauseated, a little bit crampy. So we make sure that we give our patients lots of medications for nausea, plenty of fluids.

And then they come back to our clinic, the following day for an infusion as well to make sure they’re well hydrated. Typically people feel quite queasy for the first 48 hours. It can last up to sort of five days, but for the most part, it’s the first 48 hours.

Felicity Cohen: That is so critical to understand that you’re not going to just get up and walk back out of the hospital, out of the facility where you’ve had your device inserted and go back to work that there’s going to be downtime but you don’t feel pretty terrible.

In fact, I was here last Saturday when patients had had their elipse devices inserted and they came back for their fluid rehydration, plus the antiemetic anti nausea medication that we can put in with their fluids. It is life changing, and that is something that in this clinic environment, we really stress as being important for them because we know how much better they’re going to tolerate their devices.

And the important thing is we want patients to feel comfortable to tolerate, to move beyond those early days of feeling tragic pretty quickly.

Casey Quinn: And it’s amazing what a litre of fluids and some anti nausea medication IV can do. It can really turn the corner for you. We’re going to get you through that first 48, 72 hours where you are going to be potentially feeling quite bad and make it not that bad really.

And then you, and then you feel better. Yeah. And people don’t experience long-term nausea or abdominal discomfort with the balloon. It’s just that early adjustment period. And then your body accepts it.

Felicity Cohen: So it’s pretty amazing. Once they’re inserted, they’re all pretty much acting the same way. They’re all intragastric balloon.

They all sit in the position of the stomach in the same way, but it’s the actual mechanics around insertion. It’s whether or not there’s endoscopy, anesthetic or not, and the fillable kind of style of balloon. So they, yeah, they all act the same way once they’re there, but they’ve got their various differences and, and I guess, points of difference that is perhaps the value for patients. So with the Elipse device, it stays in the stomach for 16 weeks.

What happens at 16 weeks?

Casey Quinn: Yeah. So at 16 weeks, the actual shell starts to break down and it drains. So you basically, the fluid comes out, it’s completely safe, for the individual. And then, they pass the actual plastic, or I’m not sure if it’s plastic.

Felicity Cohen: Silicon.

Casey Quinn: Silicon, sorry. Plastic doesn’t sound good. They pass the Silicon casing and sort of in a bowel motion that comes out that way.

So the advantage of that is people don’t need to represent back to hospital, have another anesthetic and endoscopy to get it removed. So that’s particularly useful for people who are perhaps living in more remote locations or it’s just not convenient. They don’t want to come back and do that again. So that’s a really, that’s a big plus with the Elipse.

Felicity Cohen: It’s a massive advantage.

Casey Quinn: Yes.

Felicity Cohen: So first of all, it’s what we call a proceduralist device, but it’s a single, only, opportunity for them to have their balloon inserted and you don’t have to come back. Yeah. I think for us in Queensland specifically, we’ve got so many remote patients. They might be firefighter workers or in the mining sector for those people who really need to get some weight off.

I’ve already seen so many in that patient population where weight is a problem. They get over 120 kilos. And in our experience that can be the limit upon which they are able to maintain their, their workplace situation. And they may lose jobs if they’re, if they get over that 120 threshold. So I’ve seen quite a few of those particular patients, explore the Elipse, you know, not just because it’s convenient and easy, but they only have to travel to us once.

Casey Quinn: Yeah. And there’s a big cost saving in that too, because when you’re at the cost of regional flights and accommodation and time off work, all those aspects as well.

Felicity Cohen: Time off work’s a big one. Yeah. So when you’re weighing up the cost ratio around, you know, which one, I think there’s a lot to be said for only one opportunity for having that procedure and not having to have a second event at all.

Downtime from work is, is important. And, you know, your loss of productivity weigh up the value and how that looks for a patient, I think is an important one to look at.

Yeah. The other part of having this particular device, same as any procedure that we do here is the long-term follow-up and working with the team. Tell me a little bit about, what does it look like from a dietary perspective and how do I dietitians work with our balloon patients? Yeah.

So our dietitians work closely with the balloon patients. Obviously it’s very, it’s a very critical aspect of losing the weight and keeping it off and they work closely around ensuring that they’re getting adequate protein, that they’re supplemented correctly.

So because we are reducing quite dramatically, the quantity of food that people consume, we need to check their bloods and make sure that they’re not having any nutrition, nutrient deficiencies, and prescribed supplements where it’s appropriate and really focus on healthy whole foods. Having a healthy lifestyle and making sure that their patient’s dietary choices are conducive with keeping the weight off once the balloon is out.

So sustainability of the diet that they choose is really, really important.

That’s one of my favorite words sustainability, because we want to sustain our weight loss. You know, when you’re going into this effort, when you’re having a device inserted and you really want this to be the one thing that ends all the diets of the past and change that story for the rest of your life.

You want sustainable outcomes. And I think that the dietitians in that whole big equation are pretty critical, their knowledge and what they can do to work with you. And I think really important to mention for people who are distanced patients, that they can access their tele health consults, whether it’s phone or Skype or FaceTime.

I know you have lots of patients who you work with who are remote, but you still working with them by any form of telehealth sign of communication.

Yeah. And there’s no issue with rapport building. There’s no issue with connection. We still managed to really connect emotionally with people and they feel understood and valued and supported.

So whilst it’s amazing to be able to meet in person with people, just a voice on the end of the line is pretty amazing when we’re all used to text messaging, having a phone conversation, even nowadays is quite novel for a lot of people. So there’s no issues with distance.

That’s fantastic.

And then beyond that, we have a beautiful team of psychologists also working with patients right throughout their 12 month journey.

Probably one of the big things with balloon patients is dealing with, eating behaviour problems. So for example, if they are an emotional eater, a comfort eater, boarder meter, stress eater, whatever those triggers are that the psychologists are pretty good at working through how to manage those concerns.

They are because they specialise in weight and body image and issues around food. So they’re very, very skilled qualified psychologists, but then they’ve got this sort of specialty stream in this line. So they’re so familiar with the stories. And whilst everyone has an individual story, often the themes of the pretty common that come forward around emotional eating.

So what I love about the psychologist that we work with and work with our patients is patients are always in really good hands and they’re very safe emotionally. And then that allows people to make progress.

I’m loving where we’re going with the balloon technology and what we’re able to offer our patients.

And I can see that it’s become so much more popular. I think that’s just because of the growth in the device technology available. And you know, that people are really latching onto the whole idea of the ellipse specifically has drawn a lot of attention to balloons their potential and what they can achieve.

So I love that we can do something that’s nonsurgical or non-intervention. For the right patient. And that’s another point that I just wanted to discuss with you that, you know, really carefully, carefully assessing right. Patient for the right device or right. Procedure to match their goals, their expectations, their medical needs is really important because they want to deliver outcomes.

Yeah. And we actually don’t want patients who are not suited for a balloon to opt for it because it sounds like it’s easier. Or that it sounds like it’s more affordable. Yeah. So what I wanted to touch on is that, you know, your, the perfect person in the first instance to really help understand what does that look like.

Because so many people will come in thinking, or I feel like I can go with the balloon because it’s not surgery and that eliminates the fear around surgery. But if they really are a surgical candidate, the last thing I would want to see for a patient. Yeah. Invest time, money. And that’s a big thing, the financial investment, if you invest in the wrong procedure, what happens?

You’re back here 12 months later, or two years later, or maybe you go somewhere else because you’re embarrassed because you need a secondary procedure. I don’t want that for anybody. What I really want is to know, and if it was me as a patient too, that I’ve got a team of experts who are going to guide me around the best decision for me.

That’s exactly right. I think I, and I think I would go one step further. My biggest concern around people not being well-informed and going with an intervention that’s perhaps not powerful enough for their needs is that they hung that as their last hope. And then they just give up altogether because they think, okay, I can’t be helped.

It failed, that’s it. But they were actually not set up with the right intervention in the first place. So honesty and integrity around the benefits and the limitations of the balloon is really important in that initial assessment that patients have with us, the nursing staff specifically.

It is reasonable and sensible to say, I want to do the least invasive, the least risky intervention that is human nature. And I think that’s, you know, in a lot of ways it’s smart, but when it comes to weight issues, we sort of, we have very good data around what intervention work at what, in what category with what sort of a person’s weight loss goals are essentially.

So we’ll work really closely with individuals in the initial assessment to sort of ascertain why they want surgery in the first instance. To get down to this weight, is it to reach a goal weight in order to have a knee replacement, for example. So where are they at? Like what’s actually driving them to want to have an intervention, to help them lose weight, and then give them an honest appraisal of what weight loss is realistic and try to steer people toward closest towards the intervention that’s going to give them what they want.

If a person perhaps is a much better candidate for say sleeve gastrectomy, but they’re just not willing or are not in a position where they want to go down that path. We still, we’re not going to rule out the balloon, but we’re going to be very, very honest and make sure that there’s once again, a worst case scenario pathway of where do we go from here?

Hope for the best, plan for the worst. If someone wants to have a balloon, but it may not be the number one intervention for them.

I think that’s really wise because a patient wanting to lose 50 kilos, choosing a balloon needs to understand that it may not deliver that. And it’s not actually intended for that.

That’s right.

But on the other hand, it could be the thing that kick-starts their progress and gives them that opportunity to get there. It’s up to you and the team to help guide and direct that decision

That’s right. It may be an individual needs to lose 15 kilos for a hip replacement. They may benefit from losing 50, but the 15 might be enough to get them the hip replacement that might improve their pain.

Then they’re more mobile and that could kick start for further weight loss for them. So it’s a very, a bespoke individual assessment that needs to happen for each individual. We don’t just go this for you, this for you just based purely on weight.

Or on patient desire who show up and say, I want a balloon.

Casey Quinn: Exactly.

Felicity Cohen: Doesn’t work that way.

And I know that that might sound awful because so many patients, especially Queenslanders, they’re super well researched, very well-informed and they have a lot of information at their fingertips that helps them kind of already decide before they get to us sometimes around what they want, but what they want might not necessarily always be the best option.

I guess best advice is trust the process, trust the team and work with them to help you make a best guided decision.

Casey Quinn: Yeah.

Felicity Cohen: I also love that you touched on orthopedic procedures because I really feel like that the balloon is such a well-positioned device to help patients when their orthopedic surgeons are saying, I can’t give you that knee replacement or the hip replacement until you lose 20 kilos.

You need to go away and lose that weight. Yeah. I’ve had so many phone calls with people who’ve just thrown their hands in the air and they’ve tried everything before it hasn’t worked, but they’re desperate for that orthopedic procedure that’s going to be life-changing for mobility, for functional fitness, the pain.

Casey Quinn: That’s right.

Felicity Cohen: And I think this is a really good opportunity to help them get to that point where they can have those procedures.

Casey Quinn: Yeah. Particularly the elipse balloon, because you’re not needing to go back in for an anesthetic. So you can plan your surgery closest. So you might have it planned at five months with the ellipse lasting for four, you know, you can kind of have that closeness there because there’s not another surgery that needs to be scheduled.

Felicity Cohen: There’s no anesthetic.

Casey Quinn: So yeah. There’s no anesthetic.

Felicity Cohen: Yeah, exactly. That’s amazing. I love that. Yeah. Awesome. Well, I’m super, super excited about all of the things that we can do for patients with balloons. Yeah.

You did also mention medical weight loss. So in some instances, We might use a combination of therapies where we might include some pharmacological intervention where the GP might recommend some form of medication.

To go with the device to give more power to that weight loss. Yes. What can you tell me a little bit about, medical weight loss and how that would work with a device like a balloon? Yeah.

Casey Quinn: So medical weight loss is, essentially medications that we prescribe that helps suppress the appetite. And it’s important to touch up these medications aren’t things like germline. So they’re not medications that affects mental functioning, anything like that.

They’re particularly good for people who have perhaps a smaller amount of weight to lose and which we’ve got to for our medical weight loss program or for people who need to sort of get that little bit more weight loss on top of the balloon, or they want to use it when the balloon comes out or as a way of kind of helping to manage their appetite.

So they’re, they’re powerful medications. And I think that in the future, they will become regular medications for people. Once they’re better subsidised by the government, because they’re fantastic for helping maintain in particular weight loss.

Felicity Cohen: Absolutely. And I love that we can use them with a device to get better results. The other thing about the medical weight loss drugs is that there’s so many different ones that where the GP and the medical team are able to work out, which ones might interact with medications that people are currently taking so they can adjust and change accordingly.

So there is typically a pharmacological treatment option for pretty much any patient. Yeah. But we’ve got to have a really good understanding of all of their medical conditions and the medications that they’re currently taking so that the GPS can prescribe appropriately.

Yeah. Fabulous. Well, I’m excited about the liters and I’m excited about the opportunity, Casey, for you to see many more patients and help them along their journey, because you do so much to help them.

Casey Quinn: Thank you.

How do you, so let’s just move off balloons for a second. Yeah. Yeah. So tell me about how you actually manage your working life. And being a mumand all the other things in life that you love to do. What, what, what for you is work-life balance?

So work life balance for me, I, I realised some time ago that happiness for me is an equation. It’s about making sure that I’m getting enough rest, that I’m exercising, that I’m surfing, that I’ve actually started journaling, doing the gratitude journal thanks to you, Felicity, which is, which has been amazing. So yeah, trying to get that work-life balance initially starts with me and being a mum, as all mums can understand and attest to, it’s really difficult to make time for yourself because you feel very self-indulgent and extremely guilty about it.

So for me, it’s been first of all, making sure I’m mentally sound that I’m physically healthy and listening to other people’s advice. Who’ve walked in my shoes before. And just because it doesn’t feel natural doesn’t mean it’s not good for you. And eventually when you start making the right choices, you, you feel a lot happier for it, then you feel more entitled to take that time for yourself.

I find work a relief. I don’t find work draining ever. When I come in work with patients, I would, I mean, it’s they say, like do a job that you would do for free. I honestly would do this job for free. I love it. I love it so much. So I feel energised at the end of my working days.

It’s probably more about managing, putting on the different hats and making sure you’re meeting everybody’s needs in the workplace and being a good mum. But I just start by trying to be a healthy within myself and be authentic and things flow on from there. And you’re so amazing. Like feel the most like genuinely mother, family friendly person to work for ever, which is so true.

So you make it easier for me to be honest. Like a lot easier.

Felicity Cohen: Thank you.

Casey Quinn: Cause you never made me feel bad about being a mumor having other needs elsewhere.

Felicity Cohen: And, and nor should anyone, you know, having children and running your life and managing work and fitting everything. Putting all those pieces of the puzzle together.

It’s not ever going to be easy. No. but I think you’re doing an amazing job and you know, doing an amazing job at every single thing that you do. And you’ve got the most gorgeous little boy he should come to work more often.

Casey Quinn: He loves it so much. He loves them.

Felicity Cohen: Yeah. Thank you for being here today. I do have one last question for you that I like to ask everybody who comes on the wellness warriors podcast.

What does wellness mean to you?

Casey Quinn: Wellness means to me, feeling excited about life, starting the day feeling excited, just feeling open to everything coming your way. And you can only feel that way if you’re not in pain, if you’re not thinking about your body, you know, like if you just kind of fresh moving forward.

So when my body is a healthy vessel, I can do that. And when it’s not, I really notice. So, I don’t even know if that makes any sense, but.

Felicity Cohen: I actually love it. I love it. You need to be excited. I love excitement is the best thing ever. You wake up and feel awesome.

Casey Quinn: You know, those days where you feel like that, and it’s not wellness every day for me, but I’m trying to make it that way.

Felicity Cohen: I think that’s a really good message that you can’t have that every single day of your life but you can strive for it.

Casey Quinn: Yeah. If you don’t strive for it, you’re not even going to get close.

Felicity Cohen: Love it. Thank you very much.

Casey Quinn: You’re welcome.

Thank you, beautiful nurse, Casey Quinn.

Thank you for joining the wellness warriors podcast. It’s been a pleasure to have you online with us. If you didn’t join the series, please leave your review, subscribe and follow it. And we look forward to sharing many more stories with you in the future.

Nutritionist & Dietitian

Meet our team


Chealse Hawk

Nutrion Leader Coach

Isabelle Cole

Nutrion Coach

Joshua Chambers

Nutrion Coach

Laura Barrett

Nutrion Leader Coach