Arturo Rodriguez, MD

December 26, 2009

Making Healthy Choices after Bariatric Surgery

Food, Glorious Food!

Making Healthy Choices after Bariatric Surgery

Bariatric surgery can help you to lose weight, but you also have to make some long-term changes to your diet in order to see the best results.  Your stomach is much smaller after bariatric surgery, and can only hold a small amount of food.  It is important to choose HEALTHY and NUTRITIOUS food in order to help reach your weight loss goal and to keep your body nourished.  Here are some general guidelines to help you in creating your own unique and healthy lifestyle.

Plan Ahead. Your new lifestyle starts at the grocery store! If you buy cookies, sweets and chips, it will be hard to resist or limit these foods when they are accessible at home. Before you buy the groceries, make a list of the foods you plan to eat during the week and include healthy choices that are easy to prepare.

Include foods from all four food groups in your diet. Vegetables and Fruits, Grain Products, Dairy and Alternatives, Meats & Alternatives. There are many healthy foods to choose from. Make your plate colorful!

Start with protein-rich foods.  Beans, lentils, chicken, fish, eggs, and dairy products are all good sources of protein.  Your body needs protein to build muscle, skin, hair, and connective tissues, and support many essential chemical reactions.  Carbohydrate-rich foods like rice, pasta and cereals are an important source of energy and vitamins, but they can fill you up quickly. Save these towards the end of your meal… and don´t forget about your vegetables and fruits, rich in vitamins and minerals too!

Eat three small meals per day.  Make sure to include breakfast every day.  Skipping breakfast can lead to over-eating at lunchtime, and you also need that energy to help you start your day.  Spread the meals out evenly throughout the day, so that you are eating every 4-6 hours.  If there is a long stretch of more than 6 hours between meals, include a small healthy “snack” to keep you going.  Perk up with a small orange (35 calories) or whole wheat crackers (2 crackers = 80 calories) with low-fat cheddar cheese (1 oz = 49 calories), instead of a chocolate bar (280 calories!) 

Drink between meals instead of with meals to help your lap band work at its best.  The lap band is designed to restrict solids, not liquids. Drinking liquids during or immediately after meals tends to flush food through your stomach pouch and you will not get the prolonged feeling of satiety that you need.  Keep your foods and liquids separate to feel fuller longer, and stay hydrated too!

 

Making Healthier Choices

Here are some simple ways to make healthier choices at meal times.

  1. Breakfast?  In your coffee or tea, replace the sugar with artificial sweetener, or add 2% milk instead of cream.  Instead of a donut or package of cookies, choose a low-fat yogurt and spoonful of granola, or a soft-boiled egg and small apple.  
  2. Lunch?  On your sandwich, use margarine instead of mayonnaise, and just spread it on one side of the bread. Add fresh vegetables to your sandwich to increase the flavor – try tomatoes, cucumbers or green peppers sliced very thin.  Mix small pieces of cooked chicken and low-fat cheese into your salad to make a fresh meal, and choose low-fat salad dressings or make your own – olive oil, balsamic vinegar, lemon juice, and a dash of pepper!

Dinner?  Steam your vegetables instead of boiling or frying them.  Try baking your fish or chicken instead of frying it in oil. If you´re looking for a flavor kick, try adding some fresh herbs and spices to your dish.  For a simple, healthy meal, wash and cut potatoes, carrots, and broccoli, and wrap them in foil together with some fresh fish and herbs – pop the foil package in the oven for 30 minutes at 400°F and enjoy a delicious hot meal!

Do I need to Avoid or Limit any Foods?

High-calorie foods.

Avoid “Empty Calorie” foods like syrup, honey, pie, jam, chips, or cake, as they contain large amounts of sugar, and will fill you up quickly while providing very little nutritional value. Although you don´t have to give up your favorite high-fat treats forever, you will need to change the amount and frequency that you indulge in these foods in order to see the best results with your lap band.  For example, if you usually eat a large bowl of ice cream in the evenings, use a smaller bowl and choose one day per week when you will enjoy your favorite flavor.  If you love soda pop, choose the diet or light version instead, but watch out – the bubbles will fill you up fast.  Remember – your bariatric surgery is a tool that you can use to help you lose weight, but it will not work without your support!

Stomach Irritants

Some foods and medications can irritate your stomach, causing inflammation which can making eating uncomfortable and increase the risk of blockages.  Avoid or limit alcohol, spicy foods like chili, and tobacco.  Some medications like aspirin or iron supplements can also cause irritation. Talk with your doctor to find a safe alternative if you require these medications, and if possible, request a liquid format.

Hard & Bulky Foods

Some foods can get stuck in your lap band or stomach pouch, which can be an uncomfortable or painful experience.  Foods like popcorn, nuts and seeds are difficult to digest and may get stuck in your lap band, blocking other foods from passing through for digestion. It is best to avoid foods that are hard or difficult to digest.  Other foods such as pasta, rice, tortillas or dry bread can be bulky and may get stuck if you do not chew them properly.  Limit these foods in order to decrease the risk of blockages.  If you eat these foods, make sure you are chewing well and eating slowly.  If you feel that they are stuck, you may need a small sip of water to help them pass through.

 

R. Pallek

Nutritionist

The Bariatric Team

http://www.thebariatric.com

Originally posted 2009-04-03 11:36:22. Republished by Blog Post Promoter

Did you like this? If so, please bookmark it,
tell a friend
about it, and subscribe to the blog RSS feed.

December 19, 2009

The Answers to Gastric Sleeve Failures

The Answers to Gastric Sleeve Failures

The Gastric Sleeve is an open procedure, and is known as part of the Duodenal Switch since 1988.  The Laparoscopic Gastric Sleeve on high risk patients started in 2004 as the first stage of the Duodenal Switch (DS) and soon after that date, several teams started Laparoscopic Gastric Sleeve programs as primary or solitary surgical procedures for morbidly obese patients. In 2007 the Gastric Sleeve was proposed as a treatment for Metabolic Disease regardless of the excess weight of the patient. 

There are no long term follow-up results currently available for Gastric Sleeve Patients as a primary procedure. However, due to the increasing popularity of the Laparoscopic Sleeve, we are starting to see an increased number of failures. What we have observed in most of the Gastric Sleeve failures is the presence of large stomachs or large sleeves instead of a small volume sleeve. We have also observed a very poor nutritional and dietary change of habits in patients exhibiting gastric sleeve failure .

gastric-sleeve-proper-size   = CLICK VIDEO

When we started performing Lap Band Procedures we were creating 50 cc pouches; soon after started creating 15 cc pouches in order to give patients restriction and to avoid failures.  We are experiencing similar conditions with the Gastric Sleeve.  The remaining stomach is too large (large sleeve) so patients don’t have adequate restriction to lose weight as we expected. The use of a smaller bougie during surgery to calibrate the size of the sleeve is imperative to avoid such technical failures. The running suture reinforcement will also help to prevent a large stretching of the sleeve.

When we started performing Gastric Sleeves we didn’t have enough appropriate follow-up care for patients because we were assuming the sleeve will work and do its job (by creating enough restriction and decreasing the Ghrelin levels to lower  hunger). The truth is that patients need to be monitored closely and assisted on a regular basis with support groups and counseling in order to succeed.

We believe that the stretching of the Sleeve over time will also play a huge role in all of the cases of failure just as we learned from the lap band. Dilated pouches (large pouches) played a huge role in Lap Band failure in the past, and now in the case of the Gastric Sleeve, failure is due primarily to a large stomach pouch or sleeve.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-09-11 19:41:17. Republished by Blog Post Promoter

Did you like this? If so, please bookmark it,
tell a friend
about it, and subscribe to the blog RSS feed.

December 12, 2009

Plastic Surgery after Bariatric Surgery (Lap band, Gastric sleeve or Gastric bypass)

Plastic Surgery after Bariatric Surgery (Lap Band, Gastric sleeve or Gastric Bypass):

I know many individuals that are attracted by the idea of starting over.  It’s important for an individual to discover what they did wrong, and how we can change.  There is a need to lose weight or to keep the weight off successfully, to change your diet, to do some kind of exercise, to get fit and to stay fit by increasing your activity, to look younger, to have a totally new body so you can improve your body image. We are often dissatisfied or discontent with what we have, especially relating to our appearance – we want more or we want to look better!

Plastic Surgery has almost become a necessity for patients that have had a Bariatric procedure such as the lap band, gastric sleeve or gastric bypass.  Patients who have undergone bariatric surgery and are looking for Plastic Surgery should know that they will need more Reconstructive Surgery than just the normal Aesthetic Procedures such as Liposuction. This means that Liposuction (the most frequent plastic surgery among all the population) or a tummy tuck would not be enough, and in most cases they will need a Plastic Surgeon who has experience working with patients that have undergone a Bariatric procedure.

Patients that have lost a lot of weight after a Bariatric procedure have different personal image concerns and plastic surgery needs.  Before performing any procedure, the doctor must consider your age, your muscle tonicity, the amount of weight loss, the skin laxity or elasticity, the skin excess and the hygiene difficulty.

Frequent Questions among Lap Band Patients

Q: When is the best time to have a Plastic surgery after my Bariatric procedure?

A: The best time for Plastic Procedures for Lap Band patients is after reaching 60% of excess weight loss.

 

Q: Where can I start?

A: You should discuss your needs first, the surgical options and the cost of each procedure with your Plastic Surgeon and at that point, start planning a Plastic Procedure on what you can afford, what you want to improve or what bothers you most.

 

Q: Should I have all plastic surgery done at once?

A:  As a Surgeon I recommend to my patients to schedule plastic surgery in phases and not to have Plastic surgery done all in one procedure.  You have to consider that most of the Plastic surgery completed on a Bariatric patient takes a lot longer than in non-obese patients and this means that the surgery will be 6-8 hrs in the OR under general anesthesia.  There is also more blood loss and many times the patient may need to have a blood transfusion if there is a lot of work needed.

 

Q: How long does it take?

A: The Tummy Tuck takes 2.5 to 6 hrs depending on the patient needs.  The breast Lift takes 3.5 hrs.  A lower body lift takes 3 to 6 Hrs.

 

Q: What is the cost?

A: The cost varies from doctor to doctor but each procedure can cost from 6 up to 10 thousand USD

 

What to expect after Plastic Surgery in Lap band patient

Most of the procedures require a one or two night hospital stay. You will need to be out of work for about 10 days after surgery and you will also have drains for 5 to 7 days.  The patient must also wear a compression garment for several months.  While the scar is healing, the patient will also need oral antibiotics.

Arturo Rodríguez, MD

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-23 08:17:51. Republished by Blog Post Promoter

Did you like this? If so, please bookmark it,
tell a friend
about it, and subscribe to the blog RSS feed.

December 5, 2009

Life After Gastric Bypass Surgery

Life After Gastric Bypass Surgery

There are a number of important things to consider for patients after they have had Gastric Bypass Surgery. Take some time to read through the information and get informed if you are considering this procedure.

Diet

After having a gastric bypass, the modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss.  Without these necessary changes, such as decreasing or limiting your intake of high-fat, high-sugar foods, you may stop losing weight or even begin to gain weight again.  Limiting high intakes of sugary foods is especially important to decrease the chance of Dumping Syndrome, where these foods move too quickly through the digestive tract into the intestine and can cause cramping, pain and discomfort, among other related symptoms.

Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their gastric bypass surgery. It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of bariatric procedure.

What is most important is that you adhere strictly to your surgeon’s recommended guidelines. The following are some of the dietary guidelines I recommend after a gastric bypass:

  • During 4 weeks you will go on a liquid diet and advance in steps to a puree/baby food type diet for one or two additional weeks and transition to an almost normal (solid food) diet after that.
  • When you start eating solid food it is essential that you chew thoroughly.
  • You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don’t drink fluids while eating. They will make you feel full before you have consumed enough food or they will flush down more food than you should be taking in.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.

Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of gastric bypass you had (open or laparoscopic). Many patients return to full pre-surgery levels of activity within six weeks of an open Gastric Bypass procedure. Patients who have had a minimally invasive laparoscopic procedure may be able to return to these activities within a week.

Birth Control & Pregnancy

It is strongly advised that women of childbearing age use effective forms of birth control during the first 16 to 24 months after a gastric bypass surgery since the fertility increases during weight loss. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.

Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still some questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years are well known if you don’t take the recommended supplements. You will take supplements of Vitamins and Minerals (such as calcium and iron) for life and have a full blood work test done at least once every year.

Support Groups

The widespread use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various issues.  Most learn, from example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Most surgeons have support groups in place to assist you with short-term and long-term questions and needs. I highly recommend enrolling into a support group.

Be cautious when turning to message boards as they are full of doctor’s coordinators or brokers more concerned with increasing business in their direction than providing support. You have to be aware of their presence and not allow them to manipulate you; they are only interested in gossiping or scaring you when you are only looking for the right answers.

Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

Arturo Rodríguez, MD

Bariatric Surgeon

http://www.thebariatric.com

http://www.bandstersforum.com

Originally posted 2008-10-26 07:45:58. Republished by Blog Post Promoter

Did you like this? If so, please bookmark it,
tell a friend
about it, and subscribe to the blog RSS feed.

Powered by WordPress

© 2000-2010 Arturo Rodriguez, MD All Rights Reserved -- Copyright notice by Blog Copyright

Canonical URL by SEO No Duplicate WordPress Plugin

Theme Tweaker by Unreal