Thursday, July 24, 2008

The Right Protein Supplement

There are many protein supplements available on the market, it is important that the right supplement that meets all the requirements that are appropriate for the bariatric patient. Just because a protein supplement is labeled "bariatric" , it does not mean it is the right one. Protein supplement come in many forms powders, ready to drink, bars. The right one should be easily integrated into your lifestyle.

A Protein shake should be around 100 -180 calories, 12 - 25 grams, 0 to 5 grams of sugar and 1 -5 grams of fiber.

The powders I used were Isopure Low carb and Nectar which is a low carb as well. I also tried Isopure Protein drink. The Isopure Protein drink comes in different flavors the best one I thought was the Alpine punch. I found that the Isopure were the most protein for the calories. The powder for one scoop is 25 grams of protein and 110 calories. I used 2 scoops and mixed it with water so I got 50 grams of protein and 210 calories. I also have Isopure protein drink which is 40 grams of protein and 160 calories. So for the day I had 90 grams of protein and 360 calories, no carb and no fat. That works for me I get the most protein which keeps my muscle mass and my body will not start to burn my muscle mass. That is one of the problems when you don't take enough protein.

Some of the other protein shakes are as follows:

Designer Protein 1 scoop 18 grams 90 calories
GNC 100% Whey Protein 1 scoop 21 grams 110 calories
Genisoy Natural Protein 1 scoop 25 grams 100 calories
pbs Nutriion Protein for Life 1 scoop 20 grams 88 calories
Jay Robb's Whey Protein 1 scoop 24 grams 113 calories
ProStat 64 2 tbsp 15 grams 60 calories
GNC Soy Protein 95 1 scoop 25 grams 130 calories
GNC Lean Protein 1 scoop 20 grams 100 calories
Trader Darwin Whey Protein 2 scoop 17 grams 130 calories

Some of the Ready to Drink/Eat Protein are as follows:

EAS AdvantEgde 1 serving(11oz) 100 calories
EAS Myoplex Low Carb 1 serving(11oz) 130 calories
Resource Optisource 4 oz. 100 calories
World Wide Pure Protein 1 serving(11oz) 160 calories
Instone High Protein Pudding 6.4 oz 100 calories

Vitamins and Mineral Supplementation

Why do you need to supplement your diet with vitamins and minerals?

With the amount and type of food you will be eating with the bariatric diet, it will be difficult to get enough vitamins and minerals from food alone. Deficiencies can develop in a matter of months. Iron, folate, B-12 and calcium are the nutrients most affected. Fat-soluble vitamins, such as vitamins A, D, E, and K may also be affected.

Within one week of the surgery you will begin your dietary supplements. Vitamin and mineral supplements must be taken for life. Also remember your vitamin and mineral levels will need to be check every 3-6 months by a metabolic physician.

A daily vitamin and mineral regimen after surgery should include a chewable or liquid multivitamin with iron, 1000 - 1500 mg of calcium and there may need to be an additional B12 and iron or other supplements as recommended.

For me I took Flinstone vitamins with iron twice a day, calcium with vitamin D twice a day, vitamin B-12 and a vitamin C all chewable. You can take any vitamin you want but some of the recommended vitamins and minerals are as follows:

Multi Vitamins
Centrum Chewable
Nature's Plus Chewable
Puritan's Pride Chewable
Isotonix Liquid
Resource Optisource Chewable
Rainbow Light Powder
GNC Liquid Ultra Mega Multi
Bariatric Advantage Chewable
Flinstone Vitamins with Iron (2 per day)

Calcium (with added vitamin D)
Caltrate (calcium carbonate)
TwinLabs chewable (calcium citrate)
Viactiv chewable (calcium carbonate)
Rainbow Light chewable (calcium citrate
Bariatric Advantage chewable (calcium citrate)
Oscal (calcium carbonate)
Citracal (calcium Citrate)

Iron
Fergon Tablet
Ferrous Gluconate
Ferrous Sulfate

Vitamin B12
Nature's Bountty Sublingual
GNC Liquid B12

Thursday, July 17, 2008

Gastric Bypass Solution

8 Golden Rules for Lap Band Success by Dr. O'Brien

Lap Band Solution

Risks and Benefits to the Surgery

Now with every surgery there are risks and benefits. So you must decide whether or not the benefits out weigh the risk. In my case taking 6 different medications, diabetes, high blood pressure and high triglycerides going to 5 different specialist every other month that the benefits very much out weighed the risk. Here are some of the benefits and some of the risks.

Benefits of LAP-BAND surgery:
Losing weight may help you live longer and reduce the chance of serious illnesses.
Your self-esteem may improve as your body changes.
You may feel more confident and willing to try new things.
You should have more energy and find everyday tasks much easier to complete.

Benefits of LAP-BAND surgery over other kinds of weight-loss operations:
Less drastic because stomach and intestines are not cut
If there is a problem, the band can be removed
You may have a shorter recovery time
The band is adjustable

Risks
But LAP-BAND surgery, like any surgery, has some risks. I’m going to go over some of the risks because it's important to understand what's involved. Keep in mind that your weight, age, past surgeries, and other medical conditions can make a difference. And health conditions like heart disease, diabetes, and other illnesses can also increase the risk of complications. If you have any questions about how these risks relate to you, please ask your surgeon. Also, there are some unusual risks that will not be covered here. So please do not consider this list complete.

There is a risk the band may slip and need to be repositioned.
For the band to work, it's important that it stays in the correct position. But the band can slip for a number of reasons. If you overeat or don't chew your food well, you can vomit. And if you throw up a lot, your stomach pouch can stretch and the band can slip out of place. If you feel sharp pain in your stomach and you're vomiting after every meal, you need to call your doctor right away. The good news is that most of the time, a slipped band can be fixed. In some cases, when it's caught early, the doctor can remove all the saline from the band and then slowly refill it again. Other times, the band needs to be repositioned with surgery, especially if the slipped band is blocking the stoma. But if the surgeon finds that the band has damaged the stomach, it can’t be repositioned until the stomach has healed.

There is a risk the band can erode, or "wear through," the stomach's wall.
If this happens, another surgery is done to remove it.While it doesn't happen often, there is a risk that the band can erode, or "wear through," the wall of the stomach. If this happens, the band no longer restricts the stomach's size and you won't feel full soon after eating. Erosion can also lead to an infection. If you stop losing weight, or gain weight, it could be a sign that the band has eroded. Band erosion can happen a couple of ways. For instance, medications like aspirin can cause sores in the stomach called "ulcers" to form. Ulcers may cause the band to eat through the stomach's wall. Drinking alcohol in excess may also cause the band to erode. In these rare cases, erosion usually happens in the first year after surgery. To treat this, the band is almost always removed with another surgery.

There is a risk of infection.
In rare cases, more surgery may be needed to treat an infection.There are several types of infections that may occur after surgery: an infection inside the surgical area, a wound infection around the cuts or the port, and a general infection like a urinary infection. While a band infection is very rare, if this happens, the band or the port may have to be removed or replaced. Signs of infections can include fever, chills, swelling, pain that gets worse, redness or fluid on your wound, or painful urination. If you feel any of these things, please call your doctor right away. The infected area may need to be drained. But most of the time, antibiotics can clear up infections. In some cases, you may need to be admitted to a hospital for special treatments.

There is a risk that after surgery, the esophagus (the muscular tube that leads to your stomach) may stretch.
This can cause acid reflux, and the band may have to be adjusted or removed.There is a risk that after surgery, the esophagus may stretch. The esophagus pushes food through when you swallow. So if it becomes stretched, it may cause acid reflux and vomiting. A stretched esophagus can be caused by a number of things: binge eating, a blocked stoma, excessive vomiting, an improperly placed band, or a band that's too tight can all lead to stretching. If this occurs, the band may have to be removed with another surgery.

There is a risk of injury to the intestines, the liver, or other organs, which may require more surgery.
While injury to the surrounding organs is rare, it's slightly more common in laparoscopic procedures because the surgeon is operating in a small space through small openings. An injury can lead to a severe infection, excessive bleeding, or long-term problems with liver or bowel function. More surgery may be needed to repair any injuries.

It is possible that your surgeon may need to switch to an open procedure during surgery.
Your surgeon may discover during the operation that for the best result, he needs to switch to an open approach. This means that larger cuts are made and more of the belly is exposed. For example, an open procedure may be needed because bleeding has made it difficult for your surgeon to view the area with the scope. If this is done, there is a slightly greater risk of an infection or injury to organs. And because the cut is larger, your recovery time will be longer as well. Again, your surgeon will only make the switch to an open operation if it is needed for a more successful surgery.

There is a risk of blood clots that, in rare cases, can be life threatening.Blood clots can form in one or both of your legs during or after surgery.
Rarely, a blood clot can travel to your heart or lungs. This can be very dangerous and can even result in death. The key to prevention is to keep blood flowing. So to help prevent clots, your surgeon may use things like compression boots or TED® support hose. Signs of blood clots include sudden shortness of breath, chest pain, and a great deal of painful swelling in one or both of your legs. If you have any of these signs, call your surgeon, or get emergency help, right away.

There is a risk of bad or allergic reactions to the anesthesia or medications that are used.
In unusual cases, you can die from these reactions.You may have a reaction to the anesthesia or medications used during or after surgery. Signs of bad reactions can vary. You may have a minor reaction like a rash. Or you may have more serious symptoms like dizziness, trouble breathing, or a swollen tongue or lips. If you feel any of these things, stop your medications and contact your doctor, or get emergency help right away. An allergic reaction can be very serious, and in rare cases, people can die. Please tell your doctor if you have ever had an allergic reaction to anything. Also tell your doctor if you, or anyone in your family, has ever had a bad reaction to anesthesia.

There is a risk of bleeding both during and after surgery.
In some cases, more surgery is needed to treat it.As with any surgery, there is a risk of bleeding during and after the operation. In most cases, your surgeon will be able to control any bleeding during surgery. In very rare cases, you may experience bleeding in the days after surgery. If this happens, there’s a chance you may need to go back into the hospital for more surgery to treat the problem.

There is a risk of dehydration, anemia, or malnutrition.
Making sure that you're getting enough water and nutrients like iron and protein is very important after surgery. If your body isn't getting what it needs, you may need to return to the hospital for treatment for a few days. If you have excessive bleeding after surgery or if you're not getting enough iron in your diet, you may become anemic. This means you have fewer red blood cells, and it may make you feel tired and look pale. If you're severely anemic you may need a blood transfusion. And to avoid dehydration, slowly sip water between meals and stay away from alcohol. If you drink alcohol, do it in moderation. The best thing to do is to follow your dietitian’s instructions on your food and drink plan very carefully.

There is a risk of a stroke, heart attack, or death.
How your body handles surgery depends on what kind of condition your body is in. Your age, the condition of your heart, prior surgeries, and other illnesses can increase the length of surgery or make surgery more complex. It’s important for you to be aware that your weight, and other weight-related illnesses, place you at higher risk for complications during any surgery or recovery period. Therefore, it's possible that you may die during surgery or the recovery period from any of the risks I mentioned earlier, or for other reasons.


But what are your alternatives:
No surgery
Of course, one alternative is to not have surgery and continue trying to lose weight with diet and exercise. But you've probably tried that already and have found that success has only been temporary. So even though NOT losing weight is an option, it's not a healthy one. You're still at a high risk for conditions like high blood pressure, diabetes, and heart disease.

Gastric BypassGastric bypass in another kind of weight-loss surgery.
But unlike a LAP-BAND, which only restricts your stomach, gastric bypass changes its size permanently. The stomach is cut and the intestines are re-routed (or "bypassed"). It can be done with a laparoscope or as an open procedure. Although you may lose weight more quickly with gastric bypass, it is a more radical surgery and more serious complications can arise.

Just some final thoughts losing weight could help save your life. But surgery is the easy part. The real work starts afterward. And it may take a couple of years before you reach your weight loss goal.
Also, the band doesn't make you exercise or commit to your new diet. You are responsible for your weight loss. LAP-BAND surgery just makes it a lot easier.

LapBand Adjustments

At around the 4-6 week point, most people have their first band "adjustment." You may also hear this called a "fill." It's important to have these done as you lose weight. It's just like tightening your belt. Your stomach needs to adjust with you as your body changes.
Some people don't need an adjustment because the band is tight enough already. Others need 2, 3, or more. If you have an adjustment, your doctor will use a thin needle to inject saline through the port so it inflates the band's inner ring. This tightens the band and narrows the stoma. How much saline is added (or removed) depends on what you need.
Band adjustments are simple office visits that only take 10 or 15 minutes. And even if you're afraid of needles, don't worry — adjustments don't hurt much at all. It kind of feels like a little sting.

I had my first adjustment around 4 weeks after surgery. It was painless and it took no time at all. Now after your adjustment you must go back to the clear liquid diet for 3 days. The the full liquid diet for a week, pureed/semi solid food for a week then full food.

I have had 3 adjustment since the surgery. Every time I had one I felt like I could eat anything and I was not getting full. It is important that you listen to your body and get these adjustments. The adjustment will help you continue the weight loss.

Review of Weight Lifting for the Beginner

One of the main things after Bariatric Surgery is exercise. There are times when your weight loss will plateau and to get you over the hump to start loosing again is exercise. Also, without eating a lot of protein you must keep your strength up so weight lifting is important. But a lot of people think that weightlifting is for burly guys, but not for you, think again. Strength training is one of the best exercises for anyone to help you stay fit, lose weight, and maintain strong bones. And it doesn't have to be expensive or difficult - this e-book will show you how.

Weightlifting has many health benefits and to couple that with your weight loss is so important for a long healthy life. Weightlifting also burns fat. The fat-burning benefits of weight lifting exercises actually go on working even when you're at rest. How can that happen?
Because muscle cells burn more energy than fat cells, and strong muscles burn more calories than flabby muscles. They also store sugar as a source of energy for the next time they're used.
The sugar stored in muscle cells doesn't turn into fat. And the improved metabolism means that you don't have to worry as much about dieting. If you've been dieting for years, weight lifting exercises are even more important, because they allow you to correct the metabolic damage caused by your low-cal diets.

This book will explain all this and more. Monica states "I'm only getting started, but this is the best-illustrated, easiest to use weightlifting booklet I've ever found. The fact that it's female-centric really *made* the decision to purchase it for me."
Michelle also states "I just started the program and I enjoy it! The book is very easy to understand and the pictures are great! I go to be at night looking forward to waking up to lift weights to challenge myself. I feel a small difference in the way my clothes fit and a huge difference about how my muscles feel (tight). Feeling the difference in the way my clothes fit really makes me yearn to lift weights and exercise. I'm very pleased with the book and have recommended it to some friends."

So to continue your weight loss journey and to help you get over the weight loss plateau buy this book and have a successful healthy journey.

Thursday, July 3, 2008

Bariatric Surgery Ideal solution

Morbid obesity nearly doubles the risk of early death and is often accompanied by severe side effects such as type 2 diabetes, high blood pressure, and heart disease. Gastric Bypass can be an ideal solution.

Join host David Granet, M.D., as he talks with world-renowned expert, Alan Wittgrove, M.D., Wittgrove Bariatric Center at Scripps Memorial Hospital, to learn more about this disease and treatment options.

Wednesday, July 2, 2008

After Surgery The Diet

After the surgery on December 27 the work began. Starting on December 28th I was only aloud 3 - 4 ounces of clear liquid every hour and a minimum 48 ounces per day. Clear liquid includes water, sugar free jello, bullion or clear broth, decaf coffee, decaf tea, diet Snapple, Crystal Light, other no calorie sugar free beverage and no calorie sugar free Popsicles. The clear liquid diet is for one week.

The second week was a high protein liquid pureed diet. Minimum 48 ounces of liquid per day and a minimum of 60 grams of protein per day. I could add protein powder to all low protein liquids. I had to sip all liquids slowly. This week included same as the first week plus fat free or 1% milk, sugar free pudding, protein shakes, sugar free yogurt and mashed cottage cheese. I also could have non-creamed pureed soups, thinned hot cereal, thinned baby food vegetables/fruits and vegetable juice. A couple points to be made here are I thinned my cereal with water and my vegetables with fat free chicken broth. Also what I did was buy a small blender called a Magic Bullet to really chop and puree my vegetables. It work really great.

Week three is a soft solid diet. All food should be pureed to the consistency of pudding. 3 to 4 tablespoons of food per meal and include protein at every meal. There is a few things to be aware of first eat protein first, the second is no fluid 30 minutes before a meal and 30 to 60 minutes after eating. The liquid will make you full faster and will not keep your stomach pouch full for a long time. The liquid will breakdown the food faster and make you hungry faster. The third thing to remember is meals should last for 30-35 minutes and lastly if you feel full stopping eating. If you don't you may get sick. You will throw up. The diet consist of 48 ounces of fluids minimum per day and 70 grams of protein per day. I had egg beater but I used the egg beaters egg whites. I also had tuna, canned salmon, not-fast cottage cheese, low-fat soft cheeses, tofu, flaky fish, no sugar added yogurt, pureed bean soup, protein shakes and soft pureed vegetables. You are allowed to eat canned fruit in its own juice, unsweetened applesauce, mashed bananas, pureed/soft peaches, pears but no fruit juices. What I like to do is mix canned tomato soup with tofu, feta cheese and salmon, it is very good. The tofu take the flavor of whatever you are making with it. I also took non-creamed mushroom soup with a canned vegetable, tofu and use my Magic Bullet and blend them and put it into the microwave. Remember you are only eating 3-4 tablespoons of food so whatever you make you can freeze or keep in the refrigerator to another meal.

Week 4 is when I started introducing solid food. I added one new food per day to determine tolerability. There are certain food that a banding patient will not be able to tolerate. For example i can not tolerate steak, chicken, rice, pasta, raw vegetables, raw fruits and bread. As I continued on I enentually included 2 - 3 ounces of protein at every meal. Each protein should be cut or grounded into extremely small pieces and the protein is eated first. Remember to have a minimum 48 ounces of fluid per day and 70 -85 grams of protein per day.

The Surgery

The surgery was on December 27, 2007. The procedure took around 30 minutes to one hour. The Band fits around the stomach and creates a small stomach pouch. The procedure is a laparoscopic procedure performed under general anesthesia. Once the surgery was over the recovery was a little longer then I expected. I stayed over night and was in the hospital until they felt I was ready to go home.

During the time I was in the hospital I saw various Doctors and Nurses. One of the Nurses I saw was a Nutritionist. She explained that for the rest of the day I would only be aloud to have two tablespoons of water every 30 minutes. The next person I saw was a Metabolic Doctor. He took me off one of my Diabetic medication called Metaformin. He also explained his role in this adventure I was about to take. The last two Nurses I saw was the Bariatric Nurses involved in the groups that are for the bariatric patients. She explained the that group meet once a month to discuss various topics, concerns or issues.

Before I left to start my weight loss adventure was to get weighed. I weighed 326 pounds.

Getting Ready For Surgery

After the decision was made to have Bariatric Surgery, many thing must be done. First a letter from your Primary doctor explaining your weight loss history. For me as I said earlier was five years worth of Jenny Craig, WeightWatchers, fad diets, over the counter diet pills, Acupuncture and many other things. Second a few medical test including a blood test, Venous Doppler test and stress test. Third was a letter from a Psychotherapist that states that you are ready for the surgery. The last letter is from a Nutritionist. All the test and the letters go to your Medical Insurance Company for approval for the surgery.

The waiting for the approval was very stressful. This was my last hope to loose this weight. But the surgery was just the beginning. After talking to the Nutritionist I realized that there was more to this then the surgery. The food in take was different, the type of food were going to different the rest of my life. But with all that it still was the right thing to do.

My last meeting was with an Exercise Physiologist. One of the most important step in this weight loss was exercise. He explained to me that once you have the surgery you should start walking. Not just 20 - 30 minutes but get out there and do 30 to 60 minutes. He said you must crawl before you walk, take baby steps. He also said that at some point the weight loss will plateau at this point some people will gain weight and give up but that is the time when working out helps a lot and pulls you through and the weight loss stays consistent.