WLS Journey Community Forums [Weight Loss Surgery Support]

Great WLS info resource

ardita — Fri, 26 Feb 2010 15:16:16 GMT

Stumbled across a blog with excellent information about the mechanics of WLS and what we need to know to get to our goal of a healthier lifestyle. Check out Pams blog at: Journey to a Healthier Me: Mechanics of Protein Absorption

MsJ-let me know if posting this reference is okay. Hope so. Lots of good info on it.

Another new person

ardita — Fri, 26 Feb 2010 00:48:16 GMT

ardita here. VSG 4/29/09. Start weight 217. Down to 165. Hope to get to 125. The going is pretty slow anymore. Love my VSG. Very uncomplicated. Feel normal again. Glad to be here. Ms. Jacquii is a sweetheart...

Gastric Banding Surgery Works for Teens

MsJacquiiC — Tue, 23 Feb 2010 16:49:31 GMT

Teens Who Got Surgery Lost More Weight Than Those Who Got Nonsurgical Treatment, Researchers Find

84% of the gastric banding group lost more than 50% of their excess weight, but just 12% of those in the lifestyle intervention group did.

Gastric banding surgery produces substantially more weight loss in obese teens than medical treatment stressing lifestyle changes only, according to a new study.

The surgery group lost 76.2 pounds on average, while the lifestyle intervention group lost 6.6 pounds over the two-year study. Put another way, 84% of the gastric banding group lost more than 50% of their excess weight, but just 12% of those in the lifestyle intervention group did, says senior study author Paul E. O'Brien, MD, director of the Centre for Obesity Research and Education (CORE) at Monash University in Melbourne, Australia.

"It is highly successful," O'Brien tells WebMD of the results for surgery, explaining that a loss greater than 50% is viewed as good by weight loss surgeons.

Other weight loss experts say the study is one of the first to compare obesity surgery with lifestyle treatment in teens. More than 17.4%, or 5 million, U.S. teens are obese.

The study is published in the Journal of the American Medical Association.

Comparing Gastric Banding to Lifestyle Intervention

O'Brien and his colleagues randomly assigned 50 Australian teens, aged 14 to 18, with a body mass index (BMI) greater than 35 either to the lifestyle intervention or gastric banding and followed them for two years.

A BMI of 30 and above is considered obese. Participants also had obesity-related medical complications such as high blood pressure, asthma, back pain, physical disability, or psychosocial problems such as low self-esteem.

O'Brien's team used the gastric band known as Lap-Band. In the procedure, a hollow silicone band is placed around the upper part of the stomach, creating a small pouch capable of holding just a small amount of food.

Monash's Centre for Obesity Research and Education receives an unrestricted research grant from Allergan, Lap-Band's manufacturer. In the U.S., Lap-Band is approved for use in severely obese adults; its use in teens is under study.

Lifestyle intervention is always tried first for obesity treatment, and if that fails, surgery may be considered. In the study's lifestyle intervention group, the teens were instructed to reduce calorie intake (to about 800 to 2,000 calories a day, depending on their weight and age) and increase activity, with a target of more than 10,000 steps a day on the pedometer and at least 30 minutes a day of physical activity.

TV and other screen time was limited to two hours a day, and a personal trainer was provided to each teen for a six-week period. Parents were involved in the lifestyle intervention and education.

The gastric banding group had the procedure done within a month of being assigned to the group. They got detailed instructions on correct eating -- for instance, having three or fewer small meals a day, eating slowly, and chewing well. They were urged to get 30 minutes or more of formal exercise every day and to keep active during the day.

Comparing Gastric Banding to Lifestyle Intervention

Twenty-four of the 25 teens in the surgery group and 18 of the 25 in the lifestyle group finished the study. Other results:

The gastric banding group lost an average of nearly 13 BMI units; the lifestyle intervention group lost 1.3 BMI units on average.
At the end of the study, none of the gastric banding group had metabolic syndrome -- a cluster of risk factors for heart disease and other ailments -- although nine had it at the start. Ten in the lifestyle group had metabolic syndrome at the start, and four of the 18 finishers did at the end.

For several reasons, the banding type of bariatric surgery is preferred over other procedures, such as gastric bypass surgery, O'Brien says. "It is gentle, safe, effective, and fully reversible," he says. "A 15-year-old will be 35 in 20 years' time. Surely we will have better ways to control weight by then. If he has a [gastric band] he can have it out, all goes back to normal, and, if needed, he can go on the new therapy. That cannot happen with procedures that create major and essentially irreversible change [such as bypass surgery]."

As good as the results were, the researchers note in their report that the surgery "is not a quick fix." In fact, 28% of teens in the surgery group needed revisions because of enlargement of the stomach or other factors. To avoid the enlargement problem, eating small meals is crucial, the researchers say.

Gastric Banding Better? Experts Weigh In

The new research confirms previous research, says John W. Baker, MD, president of the American Society for Metabolic and Bariatric Surgery and co-director of bariatric surgery, director of the medical weight loss program, and director of the general surgery residency program at Baptist Health in Little Rock, Ark.

"This is a randomized trial, that's an additional strength, [showing] banding kids did better," he tells WebMD. However, he says, the study "is not discounting the fact that medical treatment can help some."

In fact, the study "has something for everybody," says Edward H. Livingston, MD, professor and chairman of gastrointestinal and endocrine surgery at the University of Texas Southwestern Medical Center in Dallas, who wrote an editorial to accompany the study.

"You can have an impact on kids no matter what you do," he tells WebMD. The teens in the lifestyle intervention group did not have nearly as much weight loss as the banding group, he says, but they did have improvements in medical conditions that can accompany excess weight, such as blood pressure reductions.

Another value of the research, he says, is to supply scientific evidence that the banding does work for teens, information that is crucial for insurance companies to have when considering whether to pay for the surgery.

The new study results are consistent with those by others that have looked at adults, says Paresh C. Shah, MD, chief of laparoscopic services at Lenox Hill Hospital in New York, who also reviewed the study for WebMD. But the Australian researchers, he says, "have added to the experience and understanding of the role for surgery in the most challenging and controversial of patients, the obese adolescent."

Even so, he says, no one, including the researchers, promotes the surgery as a cure. "It's the most effective long-term treatment modality," Shah says of bariatric surgery. The researchers, he says, "are careful to emphasize surgery is not a cure. There is still a lot of compliance necessary on the patient's and family's behalf."

Kathleen Doheny - WebMD Health News
Source

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Questions Remain On Bariatric Surgery For Adolescents

MsJacquiiC — Tue, 23 Feb 2010 16:27:15 GMT

Laparoscopic adjustable gastric banding surgery can effectively treat obesity in adolescents and seems to offer a better alternative than gastric bypass surgery, but further study is needed to determine whether it's better than nonsurgical options, a UT Southwestern Medical Center surgeon writes in an editorial in the Feb. 10 issue of the Journal of the American Medical Association.

Treatment of obesity in adolescents should be a priority because obesity portends other diseases, such as cardiac problems, hypertension and diabetes

"The latest research helps us define which surgical procedure may be preferable, but we are still a long way from settling the question of whether surgery should be used to treat obesity in teens," said Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern. The editorial accompanies a research study by Australian physicians examining weight-loss surgery among adolescents.

Treatment of obesity in adolescents should be a priority because obesity portends other diseases, such as cardiac problems, hypertension and diabetes, later in life, said Dr. Livingston, director of UT Southwestern's Clinical Center for the Surgical Management of Obesity.

Many physicians are reluctant to recommend weight-loss surgery as an obesity treatment for adolescents due to lack of research and data showing its effectiveness, Dr. Livingston said, so the latest contribution to the medical literature is a welcome addition.

While gastric bypass surgery permanently alters the stomach, laparoscopic adjustable gastric banding surgery can be reversed and has fewer complications, making it a better fit for the still-growing adolescent population, noted Dr. Livingston.

Australian researchers compared gastric banding surgery to medically supervised diets among 50 randomly assigned obese adolescents. The Australian data showed greater weight loss among patients receiving the bands, but complication rates raised questions about whether it was worth the benefit, Dr. Livingston said. In addition, the researchers found that while medical interventions successfully controlled many of the problematic disease complications without surgery, improvements were greater with surgery, he said.

Medical News Today
Source

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Well - I had a couple wow moments today!

MsJacquiiC — Tue, 23 Feb 2010 00:19:29 GMT

Well - I had a couple wow moments today actually - I'm not sure if they really classify as wow moments - but I'll share anyway :girlhide:

Took a shower this afternoon and I could actually wrap the towel around me! Before - it always seemed like even the biggest towels fit me like a large hand towel of some sort. So - I had to grin at that!
It's finally warming up in Tennessee - I'm so tired of winter and ready for spring -- So I walked to my credit union earlier today. Usually 45 minutes one-way. I call my Mom or a taxi cab to get back to the house. But I called my Mom and she didn't answer the phone ((turns out she wasn't feeling too well)) -- So instead of calling a taxi cab - I simply walked back to the house! So got in an hour and a half of walking today - and didn't even break a sweat doing it.

So... Those are my 2 wow moments for the today!

Share yours if you like :yes2:

Jacquii.

Potato Salad Alternative ((mock southern potato salad))

MsJacquiiC — Thu, 18 Feb 2010 15:48:12 GMT

This is a great substitute for potato salad found at WLS Journey Recipe Central. It's made with cauliflower and is low-carb alternative that tastes remarkably like REAL potato salad - I love it.

Enjoy :)

Jacquii.

INGREDIENTS:

1 large head cauliflower
� cup diced celery
� cup diced vidalia onion
� cup sweet pickle relish
2/3 cup light mayonnaise
3 tsp Splenda
4 tbsp yellow mustard
2/3 tbsp cider vinegar
salt & pepper to taste
3 hard boiled eggs

DIRECTIONS:
Preparation Time 10 min * | Cooking Time 8 min:

Boil the cauliflower for about 8 minutes in salted water. Let cool and cut into cubes. *
Mix all ingredients (except for the hard boiled eggs) together and pour over cauliflower.
Chop hard boiled eggs and mix into salad mixture. *

* Let the cubed cauliflower and hard boiled eggs sit overnight in the refrigerator before adding ingredients together. What results is a nicely chilled salad.

NUTRITIONAL INFO:
4 servings | 179 Calories | 9g Protein | 15g Carbohydrates | 10g Fat

Hello there!

Mysstwalker — Mon, 08 Feb 2010 19:09:13 GMT

Howdeh! My name is Michelle, and I am a sex addic....oh wait, wrong group heh. NOT REALLY, JUST A TWISTED SENSE OF HUMOR! Ok, I will behave.

My name is Michelle, as you know already lol, and I had my surgery on January 30th 2008 with Dr. Krahn here in Riverside/San Bernardino. I had lap RNY plus he put on some kind of silastic ring or something, think its a Fobi something, anyways, since my surgery I have lost 325 pounds!

Over time, I shall publish more more of my exciting death defying stupendous incredible adventures in WLS! Look forward to posting with all you fine people!

What is Obesity? Definitive with Factors, Treatments & Risks Explained...

MsJacquiiC — Mon, 08 Feb 2010 06:21:19 GMT

What is Obesity?

An obese person has accumulated so much body fat that it might have a negative effect on their health. If a person's bodyweight is at least 20% higher than it should be, he or she is considered obese. If your

If your Body Mass Index is between 25 and 29.9 you are considered overweight...

Body Mass Index (BMI) is between 25 and 29.9 you are considered overweight. If your BMI is 30 or over you are considered obese.

What is Body Mass Index (BMI)?

The BMI is a statistical measurement derived from your height and weight. Although it is considered to be a useful way to estimate healthy body weight, it does not measure the percentage of body fat. The BMI measurement can sometimes be misleading - a muscleman may have a high BMI but have much less fat than an unfit person whose BMI is lower. However, in general, the BMI measurement can be a useful indicator for the 'average person'.

CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

Increased consumption of sweetened drinks has contributed significantly to the raised carbohydrate intake of most young American adults over the last three decades. The consumption of fast-foods has tripled over the same period.

Why do people become obese?

People become obese for several reasons, including:

Consuming too many calories.
People are eating much more than they used to. This used to be the case just in developed nations - however, the trend has spread worldwide. Despite billions of dollars being spent on public awareness campaigns that attempt to encourage people to eat healthily, the majority of us continue to overeat. In 1980 14% of the adult population of the USA was obese; by 2000 the figure reached 31%.

In the USA, the consumption of calories increased from 1,542 per day for women in 1971 to 1,877 per day in 2004. The figures for men were 2,450 in 1971 and 2,618 in 2004. Most people would expect this increase in calories to consist of fat - not so! Most of the increased food consumption has consisted of carbohydrates (sugars). Increased consumption of sweetened drinks has contributed significantly to the raised carbohydrate intake of most young American adults over the last three decades. The consumption of fast-foods has tripled over the same period.

Various other factors also may have contributed to America's increased calorie and carbohydrate intake:
- In 1984 the Reagan administration freed up advertising on sweets and fast foods for children - regulations had previously set limits.
- Agricultural policies in most of the developed world have led to much cheaper foods.
- The US Farm Bill meant that the source of processed foods came from subsidized wheat, corn and rice. Corn, wheat and rice became much cheaper than fruit and vegetables.
Leading a sedentary lifestyle.
With the arrival of televisions, computers, video games, remote controls, washing machines, dish washers and other modern convenience devices, the majority of people are leading a much more sedentary lifestyle compared to their parents and grandparents. Some decades ago shopping consisted of walking down the road to the high street where one could find the grocers, bakers, banks, etc. As large out-of-town supermarkets and shopping malls started to appear, people moved from using their feet to driving their cars to get their provisions. In some countries, such as the USA, dependence on the car has become so strong that many people will drive even if their destination is only half-a-mile away.

The less you move around the fewer calories you burn. However, this is not only a question of calories. Physical activity has an effect on how your hormones work, and hormones have an effect on how your body deals with food. Several studies have shown that physical activity has a beneficial effect on your insulin levels - keeping them stable. Unstable insulin levels are closely associated with weight gain.
Not sleeping enough.
If you do not sleep enough your risk of becoming obese doubles, according to research carried out at Warwick Medical School at the University of Warwick. The risk applies to both adults and children. Professor Francesco Cappuccio and team reviewed evidence in over 28,000 children and 15,000 adults. Their evidence clearly showed that sleep deprivation significantly increased obesity risk in both groups.

Professor Cappuccio said, "The 'epidemic' of obesity is paralleled by a 'silent epidemic' of reduced sleep duration with short sleep duration linked to increased risk of obesity both in adults and in children. These trends are detectable in adults as well as in children as young as 5 years."

Professor Cappuccio explains that sleep deprivation may lead to obesity through increased appetite as a result of hormonal changes. If you do not sleep enough you produce Ghrelin, a hormone that stimulates appetite. Lack of sleep also results in your body producing less Leptin, a hormone that suppresses appetite.
Endocrine disruptors, such as some foods that interfere with lipid metabolism.
A team from the University of Barcelona (UB) led by Dr Juan Carlos Laguna published a study in the journal Hepatology that provides clues to the molecular mechanism through which fructose (a type of sugar) in beverages may alter lipid energy metabolism and cause fatty liver and metabolic syndrome.

Fructose is mainly metabolized in the liver, the target organ of the metabolic alterations caused by the consumption of this sugar. In this study, rats receiving fructose-containing beverages presented a pathology similar to metabolic syndrome, which in the short term causes lipid accumulation (hypertriglyceridemia) and fatty liver, and eventually leads to hypertension, resistance to insulin, diabetes and obesity.

Poorly balanced diets and the lack of physical exercise are key factors in the increase of obesity and other metabolic diseases in modern societies. In epidemiological studies in humans, the effect of the intake of fructose-sweetened beverages also seems to be more intense in women.

Although there appears to be a consensus on the negative effects of fructose-sweetened beverages there is still some debate over the effects of fructose versus high fructose corn syrup - two studies of note are:
1. AMA Finds High Fructose Syrup Unlikely To Be More Harmful To Health Than Other Caloric Sweeteners
2. Fructose Sweetened Drinks Increase Nonfasting Triglycerides In Obese Adults
Lower rates of smoking (smoking suppresses appetite).
According to the National Institutes of Health (NIH) "Not everyone gains weight when they stop smoking. Among people who do, the average weight gain is between 6 and 8 pounds. Roughly 10 percent of people who stop smoking gain a large amount of weight - 30 pounds or more."
Medications that make patients put on weight.
According to an article in Annals of Pharmacotherapy, some medications cause weight gain. "Clinically significant weight gain is associated with some commonly prescribed medicines. There is wide interindividual variation in response and variation of the degree of weight gain within drug classes. Where possible, alternative therapy should be selected, especially for individuals predisposed to overweight and obesity."

Treatments for obesity

Obesity treatments have two objectives:

To achieve a healthy weight.
To maintain that healthy weight.

People who are obese are often discouraged because they think they have to lose a lot of weight before any benefits are experienced. This is not true. Any obese person who loses just five to ten per cent of their body weight will have significant improvement in health - this would mean between 12-25 pounds for an obese person who weighs 250 pounds.

CLICK HERE TO OPEN THE JOURNEY WEIGHT LOSS CALCULATOR!

It is important for patients to realize that a small drop in weight is a good start and a great achievement. Experts have found that obese people who lose weight slowly and constantly, say one or two pounds each week, are more successful in keeping their weight down when they have reached their target weight.

According to the Mayo Clinic, successful and permanent weight loss is best achieved as a result of increased physical activity, changing how and when you eat, and modifying your behavior. Some patients may be prescribed medication, while others might undergo weight-loss surgery.

Dietary changes

The Mayo Clinic advises obese people to reduce their total daily calorie intake and to consume more fruits, vegetables and whole grains. It is important that your diet is varied - you still need to feed yourself, and should continue to enjoy the tastes of different foods. The consumption of sugar, certain refined carbohydrates and some fats should be reduced significantly.

Ideally, you should work with your doctor, a dietician, and/or a well-known weight-loss program.

Trying to lose weight quickly by crash-dieting carries the following risks:
You may develop health problems

You will probably experience vitamin deficiencies

You chances of failure are significantly higher

People who are seriously obese may be prescribed a very low calorie liquid diet. These must be done with a health care professional.

Physical activity

The more you move your body the more calories you burn. To lose a kilogram of fat you need to burn 8,000 calories (1 pound of fat = 3,500 calories). Walking briskly is a good way to start increasing your physical activity if you are obese. Combining increased physical activity with a good diet will significantly increase your chances of losing weight successfully and permanently!

Try to find activities which you can fit into your daily routine. Anything that becomes part of your daily life, weaved into your existing lifestyle, is more likely to become a long-term habit. If you use an elevator, try getting off one or two floors before your destination and walking the rest. You could try the same when driving your car or taking any form of public transport - get off earlier and walk that bit more.

If any of your regular shops are within walking distance, try leaving your car at home. Several surveys indicated that the majority of urban car trips outside the rush hours are less than a mile long - we can all walk a mile, and should!

If you are very obese, are unfit, or have some health problems, make sure you check with a health care professional before increasing your physical activity.

Prescription medications for losing weight

Prescription medications should really only be considered as a last resort. If the patient finds it extremely hard to shed the pounds, or if his obesity has reached such a point as to significantly undermine his health, then prescription drugs may become an option.

According to the Mayo Clinic prescription medications should only be considered if:
Other strategies to lose weight have failed

The patient's BMI is over 27 and he also has diabetes, hypertension, or sleep apnea.

The patient's BMI is over 30

There are two approved drugs a physician may consider, Sibutramine (Meridia in USA/Canada, Reductil in Europe and much of the world) or Orlistat (Xenical). Bear in mind that as soon as you stop taking these drugs the overweight problem generally comes back - they have to be taken indefinitely. Some patients may not respond to these drugs, while others may find their beneficial effects may lessen somewhat after a few months.

Weight loss surgery (bariatric surgery)

Weight loss surgery (WLS) is also known as Bariatric Surgery. It comes from the Greek work baros, which means weight.

WLS is a development of cancer/ulcer operations that consisted of removing part of a patient's stomach or small intestine. Those cancer/ulcer patients subsequently lost weight after surgery. Doctors decided the procedure might be beneficial for morbidly obese patients.

In 2008 about 220,000 bariatric operations were carried out in the USA (American Society for Bariatric Surgery). As obesity levels in America and many other parts of the world grow, so does the number of bariatric procedures. About 15 million people in the U.S. have morbid obesity; only 1% of the clinically eligible population is being treated for morbid obesity through bariatric surgery. According to the American Society for Bariatric Surgery, the average female surgery patient weighs about 300 pounds.

The American Society for Bariatric and Metabolic Surgery says that Bariatric surgery can improve or resolve more than 30 obesity-related conditions, including type 2 diabetes, heart disease, sleep apnea, hypertension and high cholesterol .

Basically, bariatric surgery alters your stomach or small intestine so that you are unable to consume much food in one sitting. This reduces the total number of calories you consume each day, thus helping to lose weight.

There are two types of bariatric surgeries:
Restrictive procedures - These make your stomach smaller. The surgeon may use a gastric band, staples, or both. After the operation the patient cannot consume more than about one cup of food during each sitting, significantly reducing his food intake. Over time, some patients' stomachs may stretch and they are gradually able to consumer larger quantities.

Malabsorptive procedures - Parts of the digestive system, especially the first part of the small intestine (duodenum) or the mid-section (jejunum), are bypassed. Doctors may also reduce the size of the stomach. This procedure is generally more effective than restrictive procedures. However, the patient has a higher risk of experiencing vitamin/mineral deficiencies because overall absorption is reduced.

Health risks associated with obesity

Bone and cartilage degeneration (Osteoarthritis)
Obesity is an important risk factor for osteoarthritis in most joints, especially at the knee joint (the most important site for osteoarthritis). Obesity confers a nine times increased risk in knee joint osteoarthritis in women. Osteoarthritis risk is also linked to obesity for other joints. A recent study indicated that obesity is a strong determinant of thumb base osteoarthritis in both sexes. Data suggest that metabolic and mechanical factors mediate the effects of obesity on joints.
Coronary heart disease
Obesity carries a penalty of an associated adverse cardiovascular risk profile. Largely as a consequence of this, it is associated with an excess occurrence of cardiovascular disease morbidity and mortality.
Gallbladder disease
Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is then delivered into the bile causing it to become supersaturated. Some evidence suggests that specific dietary factors (saturated fats and refined sugars) are the primary culprit in these cases.
High blood pressure (Hypertension)
There are multiple reasons why obesity causes hypertension, but it seems that excess adipose (fat) tissue secretes substances that are acted on by the kidneys, resulting in hypertension. Moreover, with obesity there are generally higher amounts of insulin produced. Excess insulin elevates blood pressure.
High total cholesterol, high levels of triglycerides (Dyslipidemia)
The primary dyslipidemia related to obesity is characterized by increased triglycerides, decreased HDL levels, and abnormal LDL composition.
Respiratory problems
Obesity can also cause respiratory problems. Breathing is difficult as the lungs are decreased in size and the chest wall becomes very heavy and difficult to lift.
Several cancers
In 2002, approximately 41,000 new cases of cancer in the USA were thought to be due to obesity. In other words, about 3.2% of all new cancers are linked to obesity.
Sleep apnea
Obesity has been found to be linked to sleep apnea. Also, weight reduction has been associated with comparable reductions in the severity of sleep apnea.
Stroke
Rising obesity rates have been linked to more strokes among women aged 35 to 54.
Type 2 diabetes
One of the strongest risk factors for type 2 diabetes is obesity, and this is also one of the most modifiable as it can be partially controlled through diet and exercise.

Medical News Today
Source

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What Is Hypertension? What Causes Hypertension?

MsJacquiiC — Mon, 08 Feb 2010 04:46:24 GMT

Hypertension as relates to WLS: High blood pressure is one of the many comorbidities that's often associated with being overweight. Obesity predisposes to hypertension, and weight reduction sometimes lowers blood pressure.

Hypertension can best be prevented by adjusting your lifestyle so that proper diet and exercise are key components.

What Is Hypertension?

Hypertension or high blood pressure is a condition in which the blood pressure in the arteries is chronically elevated. With every heart beat, the heart pumps blood through the arteries to the rest of the body. Blood pressure is the force of blood that is pushing up against the walls of the blood vessels. If the pressure is too high, the heart has to work harder to pump, and this could lead to organ damage and several illnesses such as heart attack, stroke, heart failure, aneurysm, or renal failure.

According to Medilexicon's medical dictionary, hypertension means, "High blood pressure; transitory or sustained elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or other adverse consequences."

The normal level for blood pressure is below 120/80, where 120 represents the systolic measurement (peak pressure in the arteries) and 80 represents the diastolic measurement (minimum pressure in the arteries). Blood pressure between 120/80 and 139/89 is called prehypertension (to denote increased risk of hypertension), and a blood pressure of 140/90 or above is considered hypertension.

Hypertension may be classified as essential or secondary. Essential hypertension is the term for high blood pressure with unknown cause. It accounts for about 95% of cases. Secondary hypertension is the term for high blood pressure with a known direct cause, such as kidney disease, tumors, or birth control pills.

Some 73 million adults the United States are affected by hypertension. The condition also affects about two million teens and children.

What causes hypertension?

Though the exact causes of hypertension are usually unknown, there are several factors that have been highly associated with the condition. These include:

Smoking
Obesity or being overweight
Diabetes
Sedentary lifestyle
Lack of physical activity
High levels of salt intake (sodium sensitivity)
Insufficient calcium, potassium, and magnesium consumption
Vitamin D deficiency
High levels of alcohol consumption
Stress
Aging
Medicines such as birth control pills
Genetics and a family history of hypertension
Chronic kidney disease
Adrenal and thyroid problems or tumors

Statistics in the USA indicate that African Americans have a higher incidence of hypertension than other ethnicities.

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What are symptoms of hypertension?
There is no guarantee that a person with hypertension will present any symptoms of the condition. About 33% of people actually do not know that they have high blood pressure, and this ignorance can last for years. For this reason, it is advisable to undergo periodic blood pressure screenings even when no symptoms are present.

Extremely high blood pressure may lead to some symptoms, however, and these include:

Severe headaches

Fatigue or confusion

Dizziness

Nausea

Problems with vision

Chest pains

Breathing problems

Irregular heartbeat

Blood in the urine

How is hypertension diagnosed?

Hypertension may be diagnosed by a health professional who measures blood pressure with a device called a sphygmomanometer - the device with the arm cuff, dial, pump, and valve. The systolic and diastolic numbers will be recorded and compared to a chart of values. If the pressure is greater than 140/90, you will be considered to have hypertension.

A high blood pressure measurement, however, may be spurious or the result of stress at the time of the exam. In order to perform a more thorough diagnosis, physicians usually conduct a physical exam and ask for the medical history of you and your family. Doctors will need to know if you have any of the risk factors for hypertension, such as smoking, high cholesterol, or diabetes.

If hypertension seems reasonable, tests such as electrocardiograms (EKG) and echocardiograms will be used in order to measure electrical activity of the heart and to assess the physical structure of the heart. Additional blood tests will also be required to identify possible causes of secondary hypertension and to measure renal function, electrolyte levels, sugar levels, and cholesterol levels.

How is hypertension treated?

The main goal of treatment for hypertension is to lower blood pressure to less than 140/90 - or even lower in some groups such as people with diabetes, and people with chronic kidney diseases. Treating hypertension is important for reducing the risk of stroke, heart attack, and heart failure.

High blood pressure may be treated medically, by changing lifestyle factors, or a combination of the two. Important lifestyle changes include losing weight, quitting smoking, eating a healthful diet, reducing sodium intake, exercising regularly, and limiting alcohol consumption.

Medical options to treat hypertension include several classes of drugs. ACE inhibitors, ARB drugs, beta-blockers, diuretics, calcium channel blockers, alpha-blockers, and peripheral vasodilators are the primary drugs used in treatment. These medications may be used alone or in combination, and some are only used in combination. In addition, some of these drugs are preferred to others depending on the characteristics of the patient (diabetic, pregnant, etc.).

If blood pressure is successfully lowered, it is wise to have frequent checkups and to take preventive measures to avoid a relapse of hypertension.

How can hypertension be prevented?

Hypertension can best be prevented by adjusting your lifestyle so that proper diet and exercise are key components. It is important to maintain a healthy weight, reduce salt intake, reduce alcohol intake, and reduce stress.

In order to prevent damage to critical organs and conditions such as stroke, heart attack, and kidney failure that may be caused by high blood pressure, it is important to screen, diagnose, treat, and control hyper tension in its earliest stages. This can also be accomplished by increasing public awareness and increasing the frequency of screenings for the condition.

Medical News Today
Source

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SILS -- Single Incision Laparoscopic Surgery

MsJacquiiC — Tue, 02 Feb 2010 11:06:23 GMT

A new weight loss surgery technique known as SILS – single incision laparoscopic surgery – is now available for some bariatric operations, including the Adjustable Gastric Band and the Laparoscopic Sleeve Gastrectomy. It involves performing the entire procedure through a single small incision, ideally at the umbilicus (belly button).

SILS requires specialized instruments that are able to articulate (bend into angles), and a novel camera that can be turned to a variety of angles.

SILS is usually less painful than standard laparoscopic surgeries (4-6 small incisions), and the cosmetic effect is thought to be superior. Some obesity surgery cases still need a balance of diet and exercise after the surgery to maintain long term results.

SILS weight loss surgery is done under general anesthesia with the patient completely asleep. A small incision is placed at the umbilicus and either 3 standard trochars (tubes through which the instruments are passed) or a single specialized SILS port is placed to gain access to the abdominal space. The space is then insufflated with carbon dioxide to create enough room to manipulate the instruments.

SILS requires specialized instruments that are able to articulate (bend into angles), and a novel camera that can be turned to a variety of angles. The operation is done using the same methods as the regular laparoscopic surgery. For the adjustable gastric band procedure a tunnel under the skin and fat layer is created to place the port for later band adjustment. This is required to move it away from the umbilicus.

Postoperatively, the patient will only have one incision, usually with less pain than a weight loss surgery with 4 to 6 incisions. Also, as the scar heals and contracts it usually becomes less noticeable as it is partially hidden by the umbilicus. Most weight loss patients feel this has a better cosmetic result.

Not all patients can have the SILS approach. It is best used in patients of lower weight (BMI of 35 to 45) and whose body habitus (the physical and constitutional characteristics of an individual) is favorable. This depends on the individual patient and their surgeon’s judgment. Body mass index (BMI) is a measure of body fat based on height and weight that applies to both adult men and women.

BMI-Body Mass Index formula is a specific calculation. For basic understanding of the BMI, here is a simple example. A person who is 5’5” to 6’0” with a weight of 225 to 300 pounds could be a possible SILS candidate. For each 7 to 8 pounds of body weight, they will get 1 point of BMI. So, if you divide 250 pounds by 7 you will have an estimated BMI of 36.

CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

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Bariatric Surgery Can Be Safer Than Living With Obesity

MsJacquiiC — Tue, 02 Feb 2010 10:46:59 GMT

Bariatric weight-loss surgery may sound dangerous and complicated, but a Geisinger physician warns that the real danger may be a life of obesity.

In addition to eliminating medical complications, bariatric surgery can help patients feel more in control of their lives.

"There are risks associated with bariatric surgery, as there are with any surgical procedure, but the risks associated with the procedure may pale in comparison to the health complications that can be caused by obesity," said Christopher Still, D.O., director of the Geisinger Center for Nutrition and Weight Management.

Bariatric surgery is a weight-loss procedure that can help obese individuals significantly reduce their body weight and can improve a patient's overall health.

Obesity can lead to a variety of complications including sleep apnea, diabetes, fatty liver disease, and heart disease, all of which require medical attention, Dr. Still said, and patients who may be considering bariatric surgery are often burdened by one or more of these conditions.

"Some obesity-related conditions can be fatal, and others require chronic medication and treatment," Dr. Still said. "With the help of bariatric surgery, medical complications caused by obesity can be eliminated, and patients can enjoy a much healthier life."

To help alleviate a patient's fears before surgery, the bariatric team ensures that patients and their families are thoroughly informed and comfortable with the procedure. Prior to surgery, patients undergo medical, psychological and nutritional evaluations, plus they attend two patient support groups and three educational classes.

In addition to eliminating medical complications, bariatric surgery can help patients feel more in control of their lives. Many patients can perform daily tasks they were unable to accomplish before their weight loss, including driving, walking, exercising and yard work. Many times, bariatric surgery prompts patients to develop new, healthier habits, Dr. Still said.

"The benefits of bariatric surgery are much greater than simply losing a few pounds," Dr. Still said. "After surgery, patients are able to reclaim their health and their lives."

Quote:

About Geisinger Health System

Geisinger is a $2.1 billion integrated health services organization widely recognized for its innovative use of the electronic health record, and the development and implementation of innovative care models including advanced medical home and ProvenCare ("warranty") program. The system serves more than 2.3 million residents throughout 42 counties in central and northeastern Pennsylvania.

Geisinger Health System
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Gastric Bypass Surgery Not More Risky for Senior Citizens Than Young

MsJacquiiC — Tue, 02 Feb 2010 10:27:27 GMT

About 26% of seniors 65 and older in U.S. are obese, nearly 40% are overweight, putting them at a higher risk for Type 2 diabetes, high blood pressure and heart disease

We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.

Morbidly obese seniors, age 65 and over, who had laparoscopic gastric bypass surgery lost nearly 76 percent of their excess weight after two years and had low complication rates and short hospital stays comparable to younger surgical patients, according to a new study presented today at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

“Bariatric surgery in the older population is underutilized because of a misperception that old age alone puts patients at higher risk for complications and mortality,” said Joseph Kuhn, MD, co-author and director of General Surgical Research at Baylor University Medical Center in Dallas, TX.

“We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.”

In one of the largest series of laparoscopic gastric bypass surgeries performed on elderly patients, researchers from Baylor University Medical Center analyzed a prospective database of 100 patients over age 65 and compared safety and outcomes to a younger population.

All patients had laparoscopic gastric bypass surgery between January 2005 and July 2008.

Prior to surgery, older patients demonstrated higher operative risk profiles compared to their younger counterparts in relation to -

sleep apnea (45% vs. 34%)
Type 2 diabetes (65% vs. 33%)
hypertension (81% vs. 57%)

Older patients ranged in age from 65 to 77 with an average BMI of 45, and younger patients ranged in age from 18 to 64 with an average BMI of 47.

Post-operative excess body weight loss (EWL) and complication rates were comparable in both groups.

At 12 and 24 months, both lost nearly the same amount of weight -- patients over age 65 showed 75.9 percent EWL after one year and 75.5 percent after two years; patients under 65 showed 77.8 percent EWL after one year and 79.2 percent after two years.

Neither group reported any deaths in the two-year follow-up period.

Post-operative complications were -

low: bleeding (>65 1% v. < 65 1.3%)
pulmonary infections (>65 3% v. <65 1.3%)
cardiac (>65 2% vs. <65 0.36%)
wound infections (>65 1% v. <65 1.7%)

Due to the age and overall health status of the older group, researchers noted it was particularly interesting to also find length of hospital stays (1.9 vs.1.3 days) and 30 day readmissions rates (6% vs. 7.4%) to be so comparable.

About 26 percent of people 65 and older in the U.S. are obese and another nearly 40 percent are overweight, putting them at a higher risk for Type 2 diabetes, high blood pressure and heart disease. Since 1990, the prevalence of obesity has increased more than 50 percent in the elderly.

“The population is getting older and unfortunately more obese, so we will see a corresponding increase in the number of patients over 65 who are eligible for bariatric surgery and surgery needs to be an option for them,” said Christopher Willkomm, MD, study co-investigator from Baylor University Medical Center.

People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesity-related disease, such as Type 2 diabetes, heart disease or sleep apnea.

According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB).

The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits.

It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information about the ASMBS, visit American Society for Metabolic and Bariatric Surgery

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Plastic surgery to complete weight-loss treatment

MsJacquiiC — Tue, 02 Feb 2010 09:40:32 GMT

He's completing their challenging journey and making them whole.

Reconfigured body after reconfigured body, the hands of Alexander Moya, M.D., Director of the Center for Weight Loss Body Contouring and Assistant Director of the Geisinger Center for Aesthetics and Cosmetic

Dr. Alexander P. Moya is the Director of Geisinger's Center for Weight Loss Body Contouring

Surgery at Geisinger Medical Center (GMC), skillfully addresses the excess skin his patients contend with following the loss of dozens, if not often hundreds, of pounds. According to Dr. Moya, it's this final therapeutic step of removing this skin and reshaping their bodies that often puts weight-loss patients at peace with themselves and what they see in the mirror every morning.

"Many patients never expected they would need to pursue plastic surgery to feel complete. It often finishes their journey as weight-loss patients," said Dr. Moya. "They look in the mirror and fear they are still big. They fear that all of that skin will somehow fill up again. They're not mentally accepting of the fact they've lost all this weight."

It's these patients that motivate Dr. Moya, who tailors every procedure to each individual he sees.

"These are the most grateful patients I've ever had. The joy I see in their faces is incredible. After undergoing our surgical procedures, they come in more confident. They're happy. It makes sense to them, why they went through bariatric surgery," said Dr. Moya.

According to Dr. Moya, the biggest reason these weight-loss patients initially seek him out is their skin.

"They've lost the elasticity in their skin and it no longer conforms to their new body size. It just sags in pockets. There's no shape to it," said Dr. Moya, who explains that plastic surgeons are trained in general body contouring but not specifically in the weight-loss area. "When I first began operating on weight-loss patients, there were complaints after undergoing the procedures I was trained on and I knew there had to be something better."

Until recently, there had been one procedure that was primarily used. This involved a single lower-body incision, similar to that of a belt, to remove excess skin of the abdomen, flanks and hips. Dr. Moya, however, felt this was insufficient, as it only treated the lower abdomen and did not give a defined waistline. The standard surgery also required surgeons to reposition the patient several times while in the operating room and the recovery period involved a two-day hospital stay.

Dr. Moya couldn't find a better surgical option so he invented it.

"Corset trunkplasty" is his new, innovative surgical technique for body contouring after major weight loss. This procedure incorporates a more complex pattern of incisions on the body, allowing for the effective removal of excess skin. The approach, performed in only one position, comprehensively removes redundant skin in a single surgery; this includes skin from just below the breastbone down to the pelvis. The result: an entirely recontoured waist. It creates a full-length and well-defined waistline such as one that would be seen with a corset.

"Corset trunkplasty" is a new, innovative surgical technique for body contouring after major weight loss. The procedure incorporates a more complex pattern of incisions on the body, allowing for the effective removal of excess skin.

The technique allows for dramatic body reshaping because it maximizes removal of excess skin and utilizes the remaining skin to close what are often very large tissue defects. Altogether, this procedure involves three incisions that are interconnected to look like an "I". Because these incisions do not extend around the entire trunk, patients do not have to be moved during the operation, making it easier to perform and resulting in an easier recovery.

"This is an aggressive body contouring approach that can provide many patients, who have various amounts of excess skin, with an aesthetically pleasing waistline, but leaving several feet of fine scars. Because of the manner in which it is performed, it is a safe technique with minimal wound healing issues. I end up shifting skin from other areas which, if not addressed, would have a negative effect on the long-term abdominal contouring result." explained Dr. Moya.

"More and more patients want to undergo this single-stage corset procedure" said Dr. Moya. "My patients are looking forward to the incredible shapes that I can provide them, regardless of the vertical scar. In fact, for many of them, it is not just about what it does on the outside but also what it does on the inside. The boost to their self-esteem trumps any external scar."

As for patient satisfaction, patients tell Dr. Moya they can't believe the huge transformation they've undergone. Many can't believe they have what they consider to be a "normal" body. These patients now can look in the mirror and see a smoother, well-defined waist with the loss of at least several inches off their waistline.

Three years later, the corset trunkplasty has become a more recognized procedure for the massive weight loss patient. In fact, Dr. Moya teaches a course at Geisinger, which attracts plastic surgeons throughout the country who are interested in learning how to perform the technique. In addition, a recent course was sent via a live feed to plastic surgeons at the University of Miami. He has also had the honor of presenting his contouring approach at three major plastic surgery conferences.

"This is exciting. It's creating a buzz in the plastic surgery field," he said.

According to Dr. Moya, plastic surgery is often the final phase of a patient's weight-loss journey. Bariatric surgery addresses the physical health; plastic surgery can address the patient's emotional health.

"I listen to my patients. I have to understand what they're looking for. What are their concerns about their body? What's the most important thing?" said Dr. Moya. "We talk extensively so that I can understand who they are and what they're looking for. This is a model that gives plastic surgeons the most success."

After presenting the patient with several options, he/she can decide what works best for them.

"My job is to make sure that if they pick this procedure that it's right for them. About 99 percent of the patients you treat are happy that you addressed the issue they came in to see you about. Plastic surgeons should learn as many contouring techniques as they can and then tailor them to the patient. This leads to a great outcome both mentally and physically," said Dr. Moya.

About 85 percent of Dr. Moya's patients are women ranging in age from 20 to 70, with the average age around 43. His patients have lost anywhere from 80 to 350 pounds.

Quote:

Dr. Alexander P. Moya, board-certified plastic surgeon, is the Director of Geisinger's Center for Weight Loss Body Contouring, as well as the Assistant Director of the Geisinger Center for Aesthetics and Cosmetic Surgery.

With special interests in body contouring after weight loss, Dr. Moya has developed an innovative surgical technique for trunk contouring, known as corset trunkplasty. This procedure uses advanced technology to provide improved surgical outcomes.

quoted from Geisinger Center for Aesthetics & Cosmetic Surgery

Geisinger Health System
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Bariatric Surgery Can Break Obesity Cycle

MsJacquiiC — Tue, 02 Feb 2010 09:16:59 GMT

Obesity is a condition that often follows family lines, but bariatric surgery offers hope for breaking this generational pattern.

Patients who are most successful after bariatric surgery must adapt to healthy diet and exercise, and many times this new lifestyle will rub off on family members, resulting in a healthier family unit.

"Bariatric surgery is part of a transformational lifestyle change," said Christopher Still, D.O., director of the Geisinger Center for Nutrition and Weight Management. "Patients who are most successful after bariatric surgery must adapt to healthy diet and exercise, and many times this new lifestyle will rub off on family members, resulting in a healthier family unit."

While genetics can play a role in obesity, other familial factors can be major contributors to this health issue, said Dr. Still. A 2008 study in the American Journal of Sociology concluded that a family's lifestyle has a major impact on whether teenagers will end up overweight, and according to the Center for Disease Control (CDC), a person's environment and behavior play a large role in obesity.

"Oftentimes, obesity is caused by preventable factors such as poor eating habits or a lack of physical activity," said Dr. Still. "These tendencies are strongly influenced by the people around us. After bariatric surgery, a patient who begins exercising and eating healthier can impart new, healthy habits on their family and help break unhealthy behaviors and ultimately obesity."

Evidence has also shown that women who undergo bariatric surgery before becoming pregnant are less likely to have children that become obese. According to a recent study in the Journal of Clinical Endocrinology & Metabolism, the intrauterine environment is crucial in a child's development, and after bariatric surgery, a woman's uterus is less likely to contain substances within the amniotic fluid that can contribute to a child's likelihood of becoming obese.

The study observed 49 mothers who had children both before and after surgery, as well as their 111 children, who were between the ages of 2.5 and 25. Children born after the mother's weight loss surgery had lower birth weights and were three times less likely to become obese than children born before the mother's surgery. Children born after surgery also had better blood sugar resistance and lower cholesterol.

"Bariatric surgery has effects far beyond simply helping a patient lose weight, and some of the changes in their bodies can be life-altering," Dr. Still said. "The changes that women go through can lessen the likelihood that they have a child who will become obese, presenting another way that bariatric surgery can help break the cycle of obesity."

Geisinger Health System
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New surgery targets weight loss (ROSE Procedure)

MsJacquiiC — Tue, 02 Feb 2010 08:44:01 GMT

A new incision-free procedure offers a less invasive option for gastric bypass patients who need surgery to "tighten up" their stomach pouches and get back on track with weight loss.

In traditional approaches, surgeons make an incision in the abdomen and repair the stomach pouch. They often also tighten the stoma.

The ROSE (Restorative Obesity Surgery, Endoluminal) procedure means less pain and a quicker recovery than traditional surgeries, said Elliott Fegelman, the surgeon who performs the procedure at Kenwood's Jewish Hospital.

But it's also a reminder that gastric bypass surgery, often the option of last resort, isn't always a permanent fix for obesity.

Weight-loss surgeries have grown in popularity since the early 1990s, reflecting both the increase in obesity and improved surgical technique. In recent years, newer, less invasive procedures have fueled some of that growth, but gastric bypass remains the gold standard for morbidly obese patients.

In gastric bypass surgery, doctors reduce the size of the stomach with sutures or staples, which limits the amount of food a patient can eat, and re-route a portion of the intestine to restrict the number of calories a patient absorbs from digesting food.

It's a drastic surgery, and patients have to follow strict post-surgical diets and start exercise routines to maintain the weight loss. But it lets morbidly obese patients lose more than half of their excess weight and it has been shown to cure type 2 diabetes in adults and teens.

But gastric bypass surgery isn't a sure-cure for obesity. About 12 percent to 15 percent of people who have the surgery gain back some of the weight. In most cases, experts say, it's because they didn't follow the post-surgery plan.

A small percentage of people who regain weight - no firm data is available - undergo corrective surgery to restore their stomach pouches to the size they were immediately after the gastric bypass.

The ROSE procedure is the latest surgery option, Fegelman said. It's been available for about two years nationally, but Fegelman performed the first procedure at Jewish in December.

In traditional approaches, surgeons make an incision in the abdomen and repair the stomach pouch. They often also tighten the stoma, or connection between the intestine and stomach. In some cases, the surgery can be done laparoscopically, using a small incision and tiny surgical tools.

Click the "Play Video" button to view procedure animation. Learn more about The ROSE Procedure in our community forums.

In the ROSE procedure, a surgeon threads an endoscope down a patient's throat and esophagus into the stomach, then uses specially designed tools to suture up the stomach pouch and stomach.

The procedure takes about an hour and a half, Fegelman said, and requires general anesthesia.

Patients can go home the same day, he said. "They have a sore throat, and that's about it," he said.

The procedure costs about $12,000, and it isn't covered by insurance.

Cost for a gastric bypass averages about $15,000 to $16,000. Some insurers cover it, but they don't usually cover any corrective procedures.

Diana Schwallie, 61, of Sardinia underwent the ROSE procedure Dec. 17. She had gastric bypass surgery five years ago, and lost about 100 pounds.

Her extra pounds caused several health problems, including high blood pressure and type 2 diabetes. After the gastric bypass surgery, they went away.

"The diabetes disappeared. I went down to minimal blood pressure medicine. I was able to get rid of several medications," Schwallie said.

The weight loss lasted for a few years, then the pounds creeped back - about 40 of them.

Since the ROSE procedure, Schwallie has lost about 15 pounds.

In some cases - about 5 percent of the time - gastric bypass surgery stops working because the stomach pouch or stoma wasn't constructed properly in the first place, said George Kerlakian, medical director of the Weight Management Center at Good Samaritan Hospital.

The rest of the time, the pounds reappear because patients aren't following the strict regimen of diet and exercise recommended following the surgery, experts say.

"The key thing is aftercare," said John Baker, a Little Rock, Ark., bariatric surgeon and president of the American Society for Metabolic and Bariatric Surgeon. "We need patients to come in for follow-up. We encourage them to come in for support groups, and to lets us monitor what they're doing in terms of weight-loss, their meal plans and their exercise."

Schwallie realized she was eating more than she should have after her original surgery without really noticing it. "When I first had the surgery, if I ate one bite over , I would get this nauseated feeling. That just kept getting less and less, and I could eat more.''

She learned the small stomach "pouch" created during the bypass surgery had stretched, letting her stomach hold more food, and letting the weight come back.

There are risks with any surgery, but the ROSE procedure is generally safer than traditional corrective surgeries, Fegelman said.

Since her follow-up surgery, Schwallie is on a mostly liquid diet her surgeon prescribed. It's pretty close to the plan she followed immediately after her initial gastric bypass.

"It's almost like starting over," she said.

Learn more about The ROSE Procedure in our community forums.
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Obesity And Anesthesia - Yes, There Is A Connection...

MsJacquiiC — Tue, 02 Feb 2010 08:29:21 GMT

At a time of year when people make plans to drop a few pounds, perhaps even consider bariatric surgery, the American Society of Anesthesiologists (ASA) wants to ensure the public has the facts regarding one's weight and the impact it may have on his or her anesthesia experience. The ASA has launched a campaign to educate the public on the issue, and empower the patient to make important lifestyle changes, whenever possible, before going under the knife.

Obesity related changes in anatomy make airway management in this population challenging.

"The health implications of obesity are enormous. Illnesses associated with obesity such as Type 2 Diabetes, Obstructive Sleep Apnea, hypertension and cardiovascular disease have significant implications for patients requiring surgery and anesthesia," said Martin Nitsun, M.D., Clinical Assistant Professor, University of Chicago Pritzker School of Medicine, NorthShore University HealthSystem. "Obesity related changes in anatomy make airway management in this population challenging."

Airway obstruction due to Obstructive Sleep Apnea (OSA) can result in decreased airflow and oxygen in patients receiving even minimal amounts of sedation. Placement of a breathing tube (intubation) may require special equipment and techniques. Anesthesiologists have to anticipate these difficulties, prepare for them and counsel patients regarding potential complications. The ASA recommends that the best way for an obese patient to prepare for surgery and to attempt to minimize the risks associated with obesity (short of losing weight prior to elective surgery) is to have a thorough exam done by a primary care doctor prior to surgery.

Visit the Lifeline to Modern Medicine Web site today to learn more about pregnancy and obesity considerations, factors specific to bariatric surgery, Obstructive Sleep Apnea (OSA), and what to look for in ambulatory centers if you are an obese patient.

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Best to lose some weight before weight-loss surgery

MsJacquiiC — Tue, 02 Feb 2010 08:17:33 GMT

Having weight-loss surgery? Shedding a few pounds before the surgery might reduce your risk of having surgical complications, a new study hints.

Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery

A look back at the medical records of 881 patients who had weight-loss surgery found that the more weight patients lost before surgery, the less likely they were to suffer post-op complications, such as infections, blood clots, and kidney problems.

Preoperative weight changes varied among the 881 patients, ranging from modest weight gain to weight loss of more than 10 percent of excess body weight.

The post-surgery complication rate was nearly twofold higher in patients who gained weight before surgery relative to those who lost weight before surgery, Dr. Peter N. Benotti of the Saint Francis Medical Center in Trenton, New Jersey and colleagues report in the Archives of Surgery.

All of the patients had undergone open or "keyhole" Roux-en-Y gastric bypass surgery. With this procedure, staples are used to create a pouch in the stomach that can hold only a small amount of food at a time; then, a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine.

Patients who had the more-invasive open surgery were at increased risk of post-op complications, regardless of whether they gained or lost weight before the surgery, the researchers found.

The popularity of weight-loss surgery has increased in recent years and so too have the numbers of patients seeking surgery who are older and sicker, the researchers note.

As more of these high-risk patients seek out surgical weight-loss options, doctors are facing a need to identify risk factors and help prepare patients for successful surgery. The current study, the researchers say, suggests that pre-surgery weight loss may be one step that will help those having weight-loss surgery to achieve a more favorable outcome.

Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery, Benotti and colleagues note. However, others believe that mandated pre-surgery weight loss "may be a deterrent to surgery." In addition, the long term effect of shedding a few pounds before weight-loss surgery is also unclear.

CLICK HERE TO OPEN THE JOURNEY WEIGHT LOSS CALCULATOR!

In a telephone interview with Reuters Health, Benotti said patients need to know that weight-loss surgery "is not a definitive treatment." A healthy diet, lifestyle change, and behavior modification are essential for maintaining weight loss after surgery, the researcher said.

"Surgery is a carrot; it provides motivation for people knowing they will have help," Benotti said.

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Timing of weight-loss surgery in teens important

MsJacquiiC — Tue, 02 Feb 2010 08:02:07 GMT

When it comes to weight-loss surgery for very obese adolescents, having the surgery sooner rather than later may yield a better long-term outcome, new study findings hint.

'Late' referral for (weight-loss) surgery at higher body mass index values may preclude reversal of obesity or extreme obesity within the first post-operative year...

Surgical treatment for extreme obesity may be appropriate for some adolescents, Dr. Thomas H. Inge, of Cincinnati Children's Hospital Medical Center, Ohio, and colleagues note in the Journal of Pediatrics.

Based on their experience, Inge told Reuters Health, "the timing of surgery for adolescent obesity is an important consideration, as 'late' referral for (weight-loss) surgery at higher body mass index (BMI) values may preclude reversal of obesity or extreme obesity within the first post-operative year and may increase the risk of weight regain over the long term."

But regardless of body weight going into the surgery, weight-loss surgery improves cardiovascular risk factors and brings body weight down significantly in all patients, the study team found.

BMI -- calculated by dividing weight in kilograms by height in meters squared -- is a standard way to determine how fat or thin a person is. Values between 20 and 25 are typically considered normal. Any value of 30 or greater is considered obese. Morbidly obese people have a body mass index (BMI) of 40 or greater -- equal to being about 100 pounds or 50 kilograms overweight.

CLICK HERE TO OPEN THE JOURNEY BMI CALCULATOR!

To determine the effect of pre-surgery BMI status on outcomes in their younger patients, Inge's team followed 61 adolescents for a year after they underwent the most common and most effective form of weight-loss surgery for severe obesity called Roux-en-Y gastric bypass.

The procedure involves stapling off the upper portion of the stomach to create a small pouch that restricts the amount of food a person can eat at one time. The surgeon also makes a bypass from the pouch that skirts around the rest of the stomach and a portion of the small intestine, limiting the body's absorption of nutrients.

Inge's team stratified the adolescents in their study into three groups based on their pre-surgery BMI. Group 1 consisted of 23 patients with a BMI between 40.0 and 54.9. Group 2 consisted of 21 individuals with a BMI between 55.0 and 64.9, and Group 3 consisted of 17 individuals whose BMI fell between 65.0 and 95.0.

The average BMI in the overall cohort, which was 60.2 at the time of surgery, fell by roughly 37 percent at 1 year after surgery, with little variation in BMI reduction among the groups, the investigators report.

It is noteworthy, the investigators say, that subjects in Group 1 -- who had the lowest BMI going into the surgery -- had the lowest BMI a year after the surgery. Still, only 10 patients (17 percent) achieved a BMI of less than 30 at 1 year. Eight of these 10 were from Group 1.

"In this investigation, we found that most adolescents within the highest ranges of baseline BMI...remained extremely obese...despite BMI reductions averaging nearly 40 percent," the investigators note.

Adolescents "who present at higher weights and BMI values lose more weight than those who present at lower weights but also plateau at a higher weight on average," they add. "The biological and potentially behavioral reasons for this are unclear."

Regardless of pre-surgery BMI, weight-loss surgery led to a healthy reduction in blood pressure, cholesterol levels and triglycerides (harmful blood fats).

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Medical experts recognize WLS as legitimate treatment for type 2 diabetes

MsJacquiiC — Tue, 02 Feb 2010 07:38:55 GMT

A first-of-its-kind consensus statement by 50 medical experts from around the world has pronounced surgery to be a legitimate and effective treatment for type 2 diabetes, bringing the procedure a significant step closer to wider use and acceptance.

While more study has been recommended, [the consensus is that surgery is] an effective treatment for select patients with type 2 diabetes...

The report, recently published in the Annals of Surgery, illustrates the findings of the first Diabetes Surgery Summit (DSS), an international conference held at the Catholic University of Rome, Italy, where more than 50 scientific and medical experts agreed on a set of guidelines and definitions to guide the use and study of gastrointestinal surgery to treat type 2 diabetes.

"This is very good news for people in Qatar and other Gulf countries where diabetes continues to be a major health concern," says Bakr Nour, MD, professor of surgery at Weill Cornell Medical College in Qatar and vice chair of surgery at Weill Cornell Medical College in New York. "It is estimated that 15 to 20% of GCC nationals suffer from diabetes, though many may be unaware that they have it. The disease rates continue to rise both in adults and children, and prevalence among Qatari children has doubled in the past 10 years."

"While more study has been recommended, consensus about surgery as an effective treatment for select patients with type 2 diabetes means that many more patients will be considered as candidates for the procedure," says Dr. Nour. "It could mean a dramatic improvement in the quality of life for those patients for whom lifestyle changes and less invasive therapies prove insufficient."

"The recommendations from the DSS are an opportunity to improve access to surgical options supported by sound evidence, while also preventing harm from inappropriate use of unproven procedures," says the consensus paper's lead author Dr. Francesco Rubino, director of the gastrointestinal metabolic surgery program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and associate professor of surgery at Weill Cornell Medical College.

The article in the Annals of Surgery summarizes the mounting body of evidence showing that bariatric surgery effectively reverses type 2 diabetes in a high proportion of morbidly obese patients, sometimes within weeks or even days, well before the patients have lost a significant amount of body weight.

Currently, bariatric surgery is only available as a treatment for severe obesity, defined as a body mass index of 35 kg/m2 or more, according to National Institutes of Health guidelines established in 1991. The consensus statement acknowledged that the cutoff is arbitrary and not supported by scientific evidence. "With an emphasis on caution and patient safety, the statement boldly advances a revolutionary concept, the legitimacy of gastrointestinal surgery as a dedicated treatment for type 2 diabetes in carefully selected patients," explains Dr. Rubino.

Based on earlier studies and on clinical experience in other countries, Dr. Rubino and his colleagues have found that removing portions of the jejunum or duodenum — the upper part of the small intestine right below the stomach — leads to spontaneous improvement or even resolution of diabetes. The same holds true when the surgeon simply inserts a tube in that part of the intestine, allowing food to pass through without coming into contact with the area. These findings suggest that when food normally passes from the stomach into the upper end of the small bowel, it triggers a cascade of hormonal reactions that cause diabetes.

"Prevention will always be the best strategy to approach the global epidemic of diabetes," says Dr. Rubino. "But gastrointestinal surgery promises to be an important addition to the treatments available, and its study may also allow us to understand the disease mechanism in depth. We can only prevent what we truly understand."

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Hypno-Surgery...? New SLIMR-band Shrinks Appetites Without Surgery

MsJacquiiC — Tue, 02 Feb 2010 07:09:09 GMT

TORRANCE, CA - December 17, 2009 - An innovative weight loss program, the "SLIMR™ gastric band," is making its debut in the United States at the Tooley Weight Wellness Clinic in Torrance, California.

Hypnosis was approved by the American Medical Association in 1958 for use in medical and dental practice.

"The sensation of a smaller stomach suggested through hypnosis offers results similar to a physical gastric band inserted by laparoscopic surgery, commonly called a lap band. The mind is very powerful, and what you think becomes real for you," says Duncan Tooley, CHt, Certified Medical Hypnotist and developer of the program.

Tooley has developed a multi-faceted 27-week weight loss protocol that combines the power of the sub-conscious mind with the appetite-limiting features of a gastric band. Tooley's unique program provides a lower risk, lower-cost option for those considering lap band surgery, or for whom diets do not work.

Joh Smith's story of her 55-pound weight loss within a few months of receiving her hypnosis lap band was covered in the London Press earlier this year, as were similar results experienced by Marion Corns, another woman seeking weight loss. As part of the process, both women underwent a simulated lap-band surgery during a hypnosis session and afterward experienced effects normally resulting from the presence of a physical lap band.

Elaborating on the actual process of the SLIMR™ band, Tooley says, "As my client rests comfortably in hypnosis, I suggest that a narrow band of stomach-wall muscles contract to squeeze off a pouch identical to that produced by a physical lap band. Thereafter, the sensation 'I'm full' is triggered after about 1/3 cup of food fills the small pouch. The food trickles through the adjustable opening into the larger main stomach and is then digested normally. SLIMR describes both the process of installing the gastric band, Stomach-Limiting Induced Muscle Response, and the client's end result!

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While the appetite and metabolic effects of the SLIMR™ band are comparable to a surgically-implanted lap band, other aspects of the program differ substantially. "My program offers great results because it includes group support, nutritional education, and 27 weeks of hypnosis to adjust sub-conscious food habits. These features are unique to my program and lacking in the standard lap band surgery," says Tooley.

The 6-month program costs $6,977, a fraction of the $15,000-$30,000 cost of a surgical lap band procedure. A few openings are still available in clinical validations now underway at Tooley's Weight Wellness Clinic in the Medical Centre, located at 4201 Torrance Blvd, Torrance, 90503. The fee for participation in the clinical validation is only $1,977 and includes all features of the full cost program.

Tooley experienced the extraordinary power of the mind when he marshaled self-hypnosis to cure his own disability and later used it as anesthesia during hernia repair surgery. Thousands of medical studies confirm that the mind is extremely powerful in adjusting body processes when asked specifically to do so.

Hypnosis was approved by the American Medical Association in 1958 for use in medical and dental practice. It is now commonly used in hospitals and burn centers to accelerate healing and reduce or eliminate pain. Information about the medical use of hypnosis is available at Hypnosis for Wellness -- How Can You Get Pain Relief or Heal Faster?. Information about the hypnotic SLIMR gastric band for obesity can be found at Tooley Weight Wellness Clinic - SLIMR-Band Home. Mr. Tooley is an Alternative Healthcare Provider and not a California licensed healing arts practitioner. He can be reached at 310-832-0830 or by email at duncan@slimrband.com.

Join our Adjustable Gastric Banding discussion here at WLS Journey Community Forums.
Press Release Source

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Band Placement Not Associated With Increased Risk Of Kidney Stones...

MsJacquiiC — Tue, 02 Feb 2010 06:33:10 GMT

Gastric Band Placement For Obesity Is Not Associated With Increased Urinary Risk Of Urolithiasis Compared To Bypass

As morbid obesity is becoming increasingly prevalent in our western society, the surgical options for

Roux-en-y patients typically have an elevation in their urinary oxalate and a significant reduction in their urinary volume.

management of this disorder are being more widely utilized. These procedures include Roux-en-Y gastric bypass and gastric band surgery. It has been estimated that the number of bariatric surgeries performed has increased ten-fold in the past decade. It has been observed that in some patients undergoing bariatric surgery for obesity, new onset nephrolithiasis can develop.

These two studies very nicely show that patients at greatest risk are those with Roux-en-Y gastric bypass in which the normal gut flow and absorption is interrupted. These patients typically have an elevation in their urinary oxalate and a significant reduction in their urinary volume. Interestingly, patients with gastric banding appear to have a more significant reduction in their urinary volumes compared to the Roux-en-Y group of patients. However, the Roux-en-Y gastric bypass procedure results in a more significant hyperoxaluria (an excessive urinary excretion of oxalate) and hypocitraturia (excretion of urine containing an abnormally small amount of citrate, an important cause of the formation of oxalate urinary calculi).

Both of these studies note that due to the small numbers and the limited time of their study, they were unable to demonstrate that the increased urinary risk factors translated into an actual increased risk for renal stone development. However, it would seem prudent to counsel these patients even before they come to their surgical procedure with regards to dietary modifications to reduce their risk factors for renal stone development. These dietary modifications include maintaining an adequate fluid intake to potentiate a 2-liter urine output per day, 1,200 to 1,500 mg calcium citrate with Vitamin D and 500 mcg Vitamin B-12 and B-complex supplementation. Additional citrate supplementation may be important particularly in those patients with a prior history of stone disease.

Further clinical studies are still required to illustrate the effect of nutrition and pharmacologic therapy on the risk of stone development in patients undergoing bariatric surgery.

UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE
Source

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Weight-loss surgery could be new treatment for diabetes

MsJacquiiC — Tue, 02 Feb 2010 05:55:56 GMT

The discovery came about by accident more than a decade ago: Weight-loss surgery often led to dramatic improvement in the control of Type 2 diabetes, often before patients left the hospital.

[Bariatric] surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

Today, evidence of the connection is so solid that some doctors say surgery should be considered as a treatment for diabetes, regardless of a person's weight.

"We thought diabetes was an incurable, progressive disease," said Dr. Walter J. Pories, a professor of surgery at East Carolina University and a leading researcher on weight-loss surgery. "It ... is a major cause of amputations, renal failure and blindness. This operation takes about an hour, and two days in the hospital, and these people go off their diabetes medication. It's unbelievable."

As many as 86 percent of obese people with Type 2 diabetes find their diabetes is gone or much easier to control within days of having weight-loss surgery, according to a meta-analysis of 19 studies published earlier this year in the American Journal of Medicine (78 percent of patients with remission of diabetes and 86.6 percent with remission or improvement). But experts still aren't sure why obesity surgery helps resolve Type 2 diabetes or how long the effect might last. And they disagree on how big a role surgery should have in treating the illness.

This much is clear: Patients who have weight-loss surgery begin to lose weight rapidly, which by itself improves Type 2 diabetes, allowing diabetics to more easily control their blood glucose levels. But something else appears to be occurring as well.

There is strong evidence that surgery - especially gastric bypass surgery, which makes the stomach smaller and allows food to bypass part of the small intestine - causes chemical changes in the intestine, said Dr. Jonathan Q. Purnell, director of the Bionutrition Unit at Oregon Health & Science University.

Surgery somehow alters the secretion of hormones in the gut that play a role in appetite and help process sugar normally.

Multiple studies in humans and animals indicate that surgery triggers reductions in ghrelin, the hormone that stimulates hunger, and elevates levels of peptide YY and glucagon-like peptide-1, both of which act as appetite suppressants. Another theory is that surgery might alter the expression of genes that regulate glucose and fatty-acid metabolism.

The effect on diabetes can depend on the type of weight-loss surgery performed, said Dr. Pories, past president of the American Society for Metabolic and Bariatric Surgery. The highest rates of diabetes remission are seen in people who have gastric bypass - about 83 percent.

But diabetes also tends to resolve or improve in 50 percent to 80 percent of people who have lap-band surgery, in which a band is placed around the top of the stomach to make it smaller, Dr. Pories said.

Shari Roan (Los Angeles Times)
Source

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Weight Loss Surgery Helps Teen's Hearts

MsJacquiiC — Tue, 02 Feb 2010 05:32:29 GMT

Weight loss surgery quickly improves the heart health of obese teens and continues to do so for at least two years, researchers report.

At the start of the study, all the teens suffered from enlarged heart muscle. By six months, it improved and remained improved for two years...

In a study of morbidly obese children, cardiac risk factors improved within six months of bariatric surgery.

"Importantly, these improvements persisted for at least two years following profound weight loss," says Holly M. Ippisch, MD, assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center.

By reversing heart abnormalities early in life, "we can reduce their risk of heart disease as adults," she tells WebMD.

Weight Loss Surgery and Heart Health

The study, presented at the annual meeting of the American Heart Association, involved 83 morbidly obese teens, 21 of whom have been followed for two years.

Among the findings:

The average body mass index (BMI) of the teens dropped from 58 before surgery to 38 two years later. Normal BMI is 18.5 to 24.9. "One boy, who was 356 pounds at the outset, lost over 100 pounds," Ippisch says.
The percentage of youths with structural heart abnormalities decreased from 49% before surgery to 24% after two years.
Heart rate and blood pressure improved.
The ability of the heart to relax improved within six months and persisted for two years. "When the heart doesn't relax as it should, that's a sign of heart stiffness, an early precursor to heart failure," Ippisch says.
At the start of the study, all the teens suffered from enlarged heart muscle. The heart works harder yet accomplishes less pumping. By six months, it improved and remained improved for two years, she says.

Many teens are also much happier after the surgery, she says. "They say, I can get in a car and fasten the seatbelt now, I can go on a roller coaster -- all the things teens are supposed to do," Ippisch says.

Weight Loss Surgery: Who Should Get It and Who Shouldn't

Not all adolescents who are overweight should consider bariatric surgery as a way to improve their heart health, doctors warn.

Teens who are candidates for bariatric surgery include those who are morbidly obese, which for most people means being 100 or more pounds overweight or having a BMI of 40 or more as well as having a serious health condition such as diabetes, according to Stephen Daniels, MD, PhD, chairman of pediatrics at the University of Colorado in Denver.

"Teens with a body mass index of 50 or more may be candidates even if they don't have other health conditions because at that level of obesity, they often have trouble with activities of daily living," says Daniels, who moderated a news conference on childhood obesity.

Obesity Epidemic in Children Continues

Also at the meeting, researchers reported that kids today are fatter than kids a decade ago, which increases the chances they'll develop heart disease as adults.

David Crowley, MD, of Cincinnati Children's Hospital Medical Center, and colleagues studied 700 healthy children and teens: half visited their clinic between 1986 and 1988 and half were seen in 2008.

"Children today [the 2008 group] weighed an average of 11 pounds more than kids 10 years ago," he says. They were also three times more likely to be obese.

The average BMI was also significantly higher in the 2008 group: 19.9 vs. 18.1 for the 1986-1988 group.

Boys and African-Americans were at particularly heightened risk for obesity, the study showed.

"If we don't get a handle on this obesity epidemic, these children will be at risk of heart attack and stroke in middle age," Crowley says.

By Charlene Laino: WebMD Health News
Source

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Hello

gfisher — Mon, 18 Jan 2010 09:23:31 GMT

Hi -

My name is Georgi and I'm 3 months post-op GBS. The surgery was scary and the recovery has been long, but have GBS was one of the best decisions that I ever made. I've lost 69 pounds so far and am finally adapting to the lifestyle change. I already feel less pressure on my joints and find it easier to climb stairs and do long walking.

I am a social worker for a local police department and I respond to homicides, suicides, domestics, child abuse, and other situations that require crisis intervention. When I'm not working I enjoy spending time with my partner and 4 week old daughter. I also enjoy playing music and renovating my c. 1900 row house.

Installing A Husband ((ROFLMAO))

MsJacquiiC — Mon, 18 Jan 2010 03:42:32 GMT

Ever written to or talked with tech support regarding an upgrade to your computer system? Fun times eh? Well - try upgrading to marriage and "Installing A Husband" ROFLMAO

Quote:

Dear Tech Support,

Last year I upgraded from Boyfriend 5.0 to Husband 1.0 and noticed a distinct slow down in overall system performance, particularly in the flower and jewelery applications, which operated flawlessly under Boyfriend 5.0.

In addition, Husband 1.0 uninstalled many other valuable programs, such as Romance 9.5 and Personal Attention 6.5, and then installed undesirable programs such as

NBA 5.0,
NFL 3.0and
Golf Clubs 4.1.

Conversation 8.0 no longer runs, and Housecleaning 2.6 simply crashes the system.

Please note that I have tried running Nagging 5.3 to fix these problems, but to no avail.

What can I do?

Signed,

Desperate.

And if that wasn't funny as hell - check out the Tech Support response below tehehehe...

Quote:

Goodday Desperate,

Thanks for writing Tech Support. First, keep in mind that Boyfriend 5.0 is an Entertainment Package, while Husband 1.0 is an operating system.

Please enter command: ithoughtyoulovedme. Try also downloading and installing Tears 6.2 -- Please do not forget to install the Guilt 3.0 update.

If those applications work as designed, Husband 1.0 should then automatically run the applications Jewelery 2.0 and Flowers 3.5.

However, remember, overuse of the above application can cause Husband 1.0 to default to Grumpy Silence 2.5, Happy Hour 7.0, or Beer 6.1 --- Please note that Beer 6.1 is a very bad program that will download the Farting and Snoring Loudly Beta.

Whatever you do, DO NOT under any circumstances install Mother-In-Law 1.0 (it runs a virus in the background that will eventually seize control of all your system resources.)

In addition, please do not attempt to reinstall the Boyfriend 5.0 program. This is an unsupported application and will crash Husband 1.0.

In summary, Husband 1.0 is a great program, but it does have limited memory and cannot learn new applications quickly... You might consider buying additional software to improve memory and performance. We recommend the following:

Cooking 3.0 and
Hot Lingerie 7.5
Kinky Sex 6.9

Good Luck!

Tech Support

Just a little bit of silliness - Quite inventive one if I do say so meself!

Hope ya enjoyed the laugh.

Jacquii.

Bariatric Protein Shakes (Because Protein is Essential...)

MsJacquiiC — Fri, 15 Jan 2010 11:49:08 GMT

It's important that you LOVE your bariatric protein shakes because they NEED to be a regular part of your life after weight loss surgery!

Supplementing your diet with protein drinks is a quick and easy way to ensure you get all the nutrition you need.

After surgery, it's challenging to get enough protein from food, so protein shakes help fill in the gap. Supplementing your diet with protein drinks is a quick and easy way to ensure you get all the nutrition you need.

You have two choices when it comes to protein shakes after weight loss surgery:

Make your own
Choose a ready-to-drink protein shake

This article will show you how to make your own bariatric protein shakes. You can find a variety of shake recipes -- and a realm of other WLS-friendly recipes -- at The Journey sister-site WLS Journey Recipe Central.

Make Your Own Bariatric Protein Shakes

Start with a base of water, skim milk, Lactaid milk, soymilk or nonfat yogurt (4-8oz).

Note: Using milk or yogurt instead of water will boost the overall protein content of the final protein drink and make it a little creamier, but it also adds ~ 100 calories per cup. If you become lactose intolerant after weight loss surgery, definitely no milk or yogurt for you!
Add a scoop of your favorite blendable protein powder. (See my favorite brands).
Sprinkle in some of your favorite flavorings (see my examples below) or a small amount of fruit to jazz things up.
Add ice.
Blend. Add more ice if necessary to make your shake nice and thick (if desired).

Bariatric Protein Shake Recipes

Add any of the following flavorings to your vanilla shake:

Pina Colada: 1/2 tsp. coconut extract
Latte: 1 Tbsp. instant decaf coffee
Eggnog: 1/2 tsp. rum extract
Almond Delight: 1/4 tsp. almond extract
Pumpkin Pie in the Sky: 1 tsp. vanilla extract + 1 tsp. pumpkin pie spice
Apple Pie: 1 tsp. vanilla extract + 1 tsp. apple pie spice

Add any of the following flavorings to your chocolate shake:

Mocha: 1 Tbsp. instant decaf coffee
Chocolate Mint: 1/2 tsp. peppermint extract
Chocolate Banana: 1/2 tsp. banana extract
Chocolate Almond: 1/4 tsp. almond extract

If you try these and still HATE your shake, try a different brand and/or flavor of protein and experiment with some new protein shake recipes until you come up with a combination (or 2 or 3!) that you LOVE.

See the WLS Journey Recipe Central Protein Shakes and Smoothies section or the The Journey Wet Bar subforum for further ideas.

Remember, protein shakes will be a permanent fixture in your diet so you need to experiment until you
ind something you actually look forward to drinking :girltender:

Source

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Lowfat Cheeseburger Pie

J.j Meyer — Tue, 05 Jan 2010 03:38:45 GMT

Ingredients

1lb extra lean ground turkey
1 cup Nonfat Cottage Cheese
1 Egg
1/2 Cup Chopped Onion
1 Clove Garlic (chopped)
3/4 Cup Kraft 2% Shredded Cheddar Cheese
2 Tbsp Worcestershire Sauce
1/4 cup water
3/4 cup of Heart Smart Bisquick (mix only)
4 Slices of Tomato

Directions
Preheat oven to 350
Brown Turkey Onion & Garlic in a pan
While turkey is browning mix Bisquick and water to form a dough. (add water gradually as needed for dough)Roll dough flat enough to cover a pie pan with rolling pin. (may have extra dough).
Place dough in pie pan
Mix Worcestershire Sauce in with turkey mixture
In a separate bowl, mix cottage cheese with egg
Pour turkey mixture into pie pan
Pour Cottage Cheese mixture over turkey
Top with Shredded Cheddar Cheese
Then place Tomato Slices on top and bake at 350 for 30-40 minutes.

Number of Servings: 8
Nutritional Info

* Servings Per Recipe: 8
* Amount Per Serving
* Calories: 163.5

* Total Fat: 4.5 g
* Cholesterol: 57.9 mg
* Sodium: 292.1 mg
* Total Carbs: 10.2 g
* Dietary Fiber: 0.3 g
* Protein: 20.6 g

Sour Cream Chicken Enchiladas

J.j Meyer — Tue, 05 Jan 2010 03:36:10 GMT

Ingredients

16 oz. fat free sour cream
1 can fat free cream of chicken soup
1 tbls. fresh chopped cilantro (1/2 tbls. dried)
2 1/2 cups cooked shredded chicken breast
1 can Mexican Rotel
1 cup chopped onions
16 corn tortillas
8 oz. shredded pepper jack and colby cheese blend
1 can diced green chiles

Directions
In a saucepan, mix together sour cream, soup and cilantro. Heat through and set aside.

Combine the chicken, Rotel, onions and green chiles in a pan sprayed with cooking spray. Heat until onions are transparent.

Warm the tortillas until flexible. Then, fill each tortilla with about 2 tbls. of the chicken mixture and about 1 tbls. of the cheese. Roll tortilla up and place seam side down in a 8x11 dish sprayed with cooking spray.

Pour over the sour cream sauce and top with the remaining cheese.

Bake in a 350 degree oven for about 30 minutes or until heated through.

Makes 8 servings of 2 enchiladas each.

Number of Servings: 8

Nutritional Info

* Servings Per Recipe: 8
* Amount Per Serving
* Calories: 392.1

* Total Fat: 12.4 g
* Cholesterol: 77.6 mg
* Sodium: 753.0 mg
* Total Carbs: 40.1 g
* Dietary Fiber: 3.0 g
* Protein: 31.7 g

New Post Op

Gene — Fri, 01 Jan 2010 21:16:44 GMT

Greetings I just had my wls on Dec 21. I lost 15lbs in the first week and have only lost 1.5 lbs in the last 5 days. Should I be loosing more?

cooking new

sweet50ish — Wed, 30 Dec 2009 13:33:04 GMT

:wacky:
I am looking for reciepts for the diet phases. I am post op 4 weeks and I am not sure how to cook anymore. Do you all have sugjestions?