March 21, 2018 - Wednesday
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By Dr. Andrew Kramer –

Staff and physicians offer expert, compassionate care

DR ANDREW KRAMER AT THE COMPREHENSIVE WEIGHT MANAGEMENT CENTER UNDERSTANDS WEIGHT-LOSS SURGERY PATIENTSAt Holston Valley Medical Center’s Comprehensive Weight Management Center, we focus on providing the highest quality, most comprehensive care to our patients.

As a Bariatric Surgery Center of Excellence, we are a regional leader in weight-loss – or bariatric – surgery. We strive to stay on the forefront of the latest treatments and methods, which boost our long-term experience. And our recent 3 Star Quality Bariatric Center designation from Cigna further exemplifies our center’s capabilities and success.

During the past 12 years, we’ve treated more than 2,000 people. And our surgical options have grown beyond traditional gastric bypass to include newer options such as laparoscopic banding and laparoscopic sleeve gastrectomy.

Not only have I been treating patients and their obesity – I’ve been in their shoes. Eight years ago, when I was overweight and suffering from Type II diabetes, I underwent gastric bypass.

Within 48 hours, my diabetes was gone. It happened so quickly because the operation changes the body’s metabolism – some physicians now refer to it as metabolic rather than bariatric surgery. And it is the only cure for Type II diabetes.

Bariatric patients have 90-95 percent cure rate for Type II diabetes. That’s why a lot of patients at the Comprehensive Weight Management Center aren’t necessarily obese. Many are in the 200-290 pound range but have medical issues associated with their weight.

Years ago, people thought bariatric surgery was purely cosmetic, but now people are starting to understand the medical benefits. In addition to diabetes treatment, we can help people with sleep apnea, high blood pressure and coronary disease.

Preparation for Surgery
The decision to pursue weight-loss surgery is not one to take lightly. Our patients go through a variety of classes and sessions before determining their best course of action. The process can take up to a year and includes:

  • Discussing the right treatment plan, based on medical issues and lifestyle
  • Meeting with a dietitian to learn how to eat properly
  • Undergoing a psychological evaluation to make sure patients are ready for surgery – and for the life changes that come after
  • Taking classes to prepare for the surgery
  • Joining support groups

I jokingly tell patients their surgeries are sometimes the fastest, easiest parts of the process. In the following months and years, I continue to see them because we have patients who lose weight after surgery, then slip back into old habits and start gaining weight again.

That’s why we’re so proud of the approach we’ve developed at Comprehensive Weight Management Center. From your first consultation, our nurses, nurse practitioners and physicians are by your side. We’re there to answer all of your questions, educate you and make sure you’re prepared to take this life-changing journey. Our patients truly make a change for life.

To learn more the Comprehensive Weight Management Center, and whether weight-loss surgery could be an option for you, call Wellmont Nurse Connection at 1-877-230-NURSE, or visit

Andrew Kramer, DO, FACOS, Surgeon
Dr. Andrew Kramer incorporated bariatric surgery into his practice in Lebanon, Va., in 2000 and has since performed more than 1,000 weight-loss surgeries. He also has personal experience as a  bariatric  patient, having undergone a laparoscopic gastric bypass in 2004. Board certified by the American Osteopathic Board of Surgery in General Surgery and a fellow in the American College of Osteopathic Surgeons, he is affiliated with Surgical Associates of Kingsport and serves as the bariatric program medical director for the Comprehensive Weight Management Center at Holston Valley. He is recognized by ASMBS as a Bariatric Surgery Center of Excellence surgeon. Dr. Kramer was a founding member of the Virginia Bariatric Society and is also a member of the Tennessee Bariatric Society.

Mark Kadowaki, MD, FACS, Surgeon
Dr. Mark Kadowaki received his medical degree from University of Chicago, Pritzker School of Medicine in 1986 and completed his residency at University of Chicago Hospitals in 1992. He is board certified by the American Board of Surgery. Dr Kadowaki is a fellow in the American College of Surgeons and is a member of the American Society for Metabolic and Bariatric Surgery and the Society of American Gastrointestinal Endoscopic Surgeons. He is also an instructor and course director for advanced trauma life support. Prior to practicing at Wellmont Medical Associates Surgery as a general and bariatric surgeon, he worked in Hawaii, Indiana and Illinois.

Robin McMillan, RN, MSN, FNP-BC, Nurse Practitioner
Robin McMillan received a bachelor’s degree in nursing from Saint Olaf College in Northfield, Minn., and a master of science in nursing as a family nurse practitioner at the University of Tennessee, Knoxville. She also completed a master’s degree in healthcare risk management at Finch University of Health Sciences/Chicago Medical School in North Chicago, Ill. She is licensed in the state of Tennessee as a registered nurse and advanced practice nurse with certificate and is board certified by the American Nurses Credentialing Center as a family nurse practitioner. McMillan has devoted her practice to care and education of bariatric surgery patients since 2004. She serves as the bariatric program coordinator at Holston Valley’s Comprehensive Weight Management Center, overseeing program development, patient education and clinical issues. McMillan is a member of the American Society for Metabolic and Bariatric Surgery and the Tennessee Bariatric Society.

Laura Dyck, MSRD, LDN, Registered Dietitian
Laura Dyck received a bachelor’s degree in biology and later went on to complete her master of science in human nutrition from Winthrop University in Rock Hill, S.C.  She completed her dietetic internship in various clinical, community and management settings in Rock Hill. Dyck is a registered dietitian, licensed in the state of Tennessee, and a member of the American Dietetic Association. She has worked as a clinical dietitian at Holston Valley since 2001 and joined the team at the Comprehensive Weight Management Center in 2008.

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