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Results for : "exercise"

Exercise Benefits & Events

August 09, 2016 2:25 pm

Exercise and it’s benefits for body, mind and weight loss can’t be over emphasized. Everyone can benefit from some form of exercise whether it be a brisk walk, chair exercises, exercise bands, aquatics, running, hiking or biking. As a family we try to exercise often and attempt to participate in at least one event a month or so.  These types of events tend to keep us more accountable and motivated.  The group atmosphere, energy and vibe only add to the experience. Listed below are some of our favorite exercise events.  We will update this list and add to it.

Physical Benefits:

  • Weight loss and maintenance can be a benefit of exercise. It also improves muscle function and strength.
  • Improves Type 2 Diabetes and Metabolic Syndrome
  • Reduces some Cancer Risk
  • Improved Cardiovascular Health
  • Improved “Good” cholesterol
  • Strengthens and improves Bone Health
  • Living longer
  • Improved Sleep

Mental Health Benefits:

  • Reduce Stress
  • Boosts Endorphins
  • Helps with Anxiety
  • Improved Self Confidence
  • Being in the Great Outdoors and Sunlight (increases Vitamin D)
  • Prevent Cognitive Decline
  • Sharpen Memory and Cognitive Function
  • Help with Addiction
  • Increase Relaxation

One important key note is to pay close attention to hydration with exercise, not only with fluids but electrolytes as well. Exercise increases fluid loss due to sweat and increase circulation to muscle.  You need to increase fluid intake to compensate for these losses.

Exercise events by the month:

June

The Los Angels River Ride is one of our families favorites.  Great ride for a great cause.

August

Luau 5K walk and fun run This is a fun family activity as they have a kids run and lots of activities.  It is also in Griffith Park which is a beautiful and treasured location.

September

The Prudential 401K Run is to promote saving for retirement and is a FREE event at the beautiful Rose Bowl

October

The Aloha Run brings a little Hawaiian feel to the fall.

JDRF One Walk fighting Type I Diabetes

November

City of Hope’s Walk for Hope 

December

Santa to the Sea (must bring a gift for a child)

Varying months depending on location:

Race for The Rescues

Walk from Obesity

Step Out Diabetes Walk

Get your Rear in Gear to fight Colon Cancer

CicLAvia a Los Angeles area quarterly biking event.

Sunshine, Water, Rest, Air, Exercise and Diet

May 23, 2014 4:10 pm

Sunshine, Water, Rest, Air, Exercise and Diet

Of course this is over simplified, but we can’t forget the importance of the basics in our general well being. Weight loss surgery and especially Duodenal Switch have distinctive supplement requirements that need to be individualized based on your individual needs.

Sunshine is essential to life. It provides the light that wakes us and helps to regulate wake/sleep cycles and provides us with a feeling of well being. Sunlight is not only the basis of all living things but crucial in boosting the bodies Vitamin D supply. Most Vitamin D deficiencies in the general public are caused by lack of sun exposure. It is important to note that our bodies can not accomplish Vitamin D metabolism if we are wearing sunscreen. Without adequate Vitamin D stores bones will not form properly, muscle strength is impaired and osteoporosis.  Vitamin D 1,25(OH) accumulates in cell nuclei of the intestine, where it enhances calcium and phosphorus absorption, controlling the flow of calcium into and out of bones to regulate bone-calcium metabolism. However, after weight loss surgery this mechanism can be impaired.  Addition supplementation of Vitamin D is usually required based on laboratory studies following weight loss surgery.  Duodenal Switch patients should take a dry “water miscible” type of Vitamin D3 daily. 

Water comprises 50-60% of our adult bodies.  Water is essential in cell life.  It aids in transporting vitamins, nutrients and minerals to our cells. Chemical and Metabolic reactions rely on water to remove waste products including toxins that the organs’ cells reject and removes them through urine and feces. Our body temperature is regulated by sweating and the evaporation of water on the skin. Also, effectively Lubricating our joints and acting as a shock absorber for our brain, eyes, and spinal cord. Decreased stomach size, after weight loss surgery,  limits the amount of water a person can drink at one time.  It is imperative that patients ingest enough waters and fluids after surgery. We like to see our patients consume a minimum of 64 ounces of fluids a day, more on warmer days.

Rest is something we can all use more of.  Lack of sleep can cause a whole host of health issues ranging from altered levels of hormones involved in metabolism, appetite regulation, stress response to cardiovascular health, insulin resistance, immune function and most importantly post-operatively tissue repair, muscle growth and protein synthesis.  It’s easy to take rest for granted but  do not underestimate the power of sleep.

Air is an obvious essential of life.  It is important in about every function of our cells.  After surgery it is important to lung health and tissue repair. Be aware of the type of air you are breathing.  Pollution and contaminants in the air can impair lung function.  After surgery your breathing and breathing exercises will prevent complications such as pneumonia and atelectasis.  Long term air contaminants can cause asthma and long term lung health. In addition, post surgical patients will need to use their incentive spirometers to combat lung complications.

Exercise’s health benefits can not be denied. Exercise combat health conditions and disease such as stroke, metabolic syndrome, diabetes and cardiovascular disease. It also improves emotional outlook and mood. Physical activity stimulates the brain to release chemicals that involve increasing memory function.  Exercise helps maintain healthy weight, improves energy, promotes better sleep, lowers stress and anxiety.  Needless, to say after surgery exercise is extremely important for all the above reasons but also to ward off complications such as pulmonary embolism and deep vein thrombosis.

Diet is last but definitely not least. Balance along with moderation and eating whole unprocessed foods are best ways to ensure your health.  We derive most our building blocks for cell growth from the nutrients we consume. The quality of the food we put into our bodies is important in lowering health risks such as cardiovascular disease, cancer, and weight control. Protein is crucial in muscle growth, hemoglobin, cell structure and enzymes formation.  It is extremely important after weight loss surgery to remain diligent about protein intake throughout your lifetime.

It is interesting to see how all these elements are so intertwined in their synergy to maintain health.  Most are easily found or done in nature. When engaging in one of these elements,  many of the others are needed or benefited by the doing the first. Exercise requires that you stay hydrated, deep breath, possibly out in the sunlight and therefore you will rest better. Always follow your surgeon’s orders and recommendations based on your individual health status and laboratory studies.

Elective Surgery and Anesthesia for Patients after COVID-19 Infection

January 23, 2022 6:03 pm

ASA logo - American Society of AnesthesiologistsAnesthesia Patient Safety Foundation (APSF) logo

A GUIDE TO COVID-19 TESTS FOR THE PUBLIC

January 23, 2022 5:38 pm

THE MAIN TESTS AVAILABLE FOR COVID-19

VIRUS STRUCTURE

To understand testing methods, it is helpful to understand the structure of the coronavirus SARS-CoV-2, which causes the disease COVID-19. The virus is composed of a core made up of nucleic acid (nucleic acids are what makes up the virus’s genetic code) in the form of RNA, surrounded by a coat called the envelope which contains various proteins. Spikes formed of a protein called the S (spike) protrude from the envelope. It is the S protein that attaches to cells of the human respiratory tract.

TESTING

The tests commonly available for SARS-CoV-2 can detect either:
  • the RNA − detected by the PCR test
  • the surrounding proteins − detected by the rapid lateral flow devices
  • the human body’s response to the virus – detected by antibody tests.

PCR TESTINGNUCLEIC ACIDS ARE WHAT MAKES UP THE VIRUS’S GENETIC CODE

PCR tests detect the virus’ RNA. These tests are normally carried out in a laboratory using a swab of the nose and/or throat. PCR tests can detect very tiny amounts of RNA, meaning they are extremely sensitive. They are the best test for current infection. Patients with COVID-19 usually start to become positive by PCR testing a day or two before symptoms start and will continue to test positive by PCR afterwards for some time. Repeat PCR once a diagnosis has been made is not necessary. The period the patient must isolate for is defined by time from the start of symptoms or, if there are no symptoms, from the first positive test. Current UK policy is that patients must self-isolate for ten days after this time.

WHEN SHOULD I HAVE A PCR TEST?

  • If you currently have symptoms that may indicate COVID-19, this is the test you should have to diagnose the infection.
  • If a lateral flow test is positive. The purpose of the PCR test is to confirm the diagnosis, since it is a more accurate test than the lateral flow test.

IS A PCR TEST ACCURATE?

PCR is the most accurate test available for current infection. In a person with symptoms, a positive PCR test is likely to accurately indicate infection. If a person has symptoms suggesting infection but a negative PCR test, doctors may decide to repeat the test if they still suspect infection (e.g. in hospitalised patients).

LATERAL FLOW TESTS

These are the rapid tests that are used in the community. They are convenient because they can give a result within 30 minutes and do not need a laboratory. They detect proteins from the virus, not RNA. They use a swab of the nose and/or throat and are carried out on a small flat plastic device like a pregnancy test. These tests are very different from PCR. They are not suitable for diagnosing individual patients who suspect they may be infected because they have symptoms. People with symptoms need a PCR test. Lateral flow tests are intended for picking up additional infected cases who would otherwise be missed because they don’t have any symptoms.

WHEN SHOULD I HAVE A LATERAL FLOW TEST?

  • You should only have this test if you don’t have any symptoms and have been invited to take one as part of an exercise to identify infected people without symptoms.

ARE LATERAL FLOW TESTS ACCURATE?

These tests are not as sensitive as PCR. They are simply a convenient way of picking up a proportion of undiagnosed people who have no symptoms. The way to look at these tests is that every additional positive case picked up is a bonus, preventing further unknown transmission of the virus. If a person tests positive with these tests, they need to confirm this by having a more accurate PCR. In the meantime, they must self-isolate. If these tests are negative, the person may or may not be infected and that person must continue to take the usual precautions such as hand washing, wearing a mask and social distancing. A negative lateral flow test should not be used to rule out infection or indicate that it is safe to do something such as visit relatives. You can read more about the accuracy of lateral flow tests here.

ANTIBODY TESTS

These tests detect the body’s response to a previous infection, by looking for antibodies that the body has produced. It takes some time after infection for the body to produce antibodies. So, antibody tests are not suitable for diagnosing people at the time they have symptoms. They are useful for finding out if someone has been infected in the past. This is useful, for example, for studying how many people in a population have been infected. It is not known for how long after infection antibody tests remain positive. Levels of antibody are likely to decline with time, over months or years.

WHEN SHOULD I HAVE AN ANTIBODY TEST?

  • You might be asked to have an antibody test as part of a study to see how many people have been infected in the past.
  • In future, if a doctor wanted to know if you had been infected in the past, they might perform an antibody test.

LAMP AND LAMPORE TESTING 

Like RT-PCR, LAMP and LampORE tests detect the viral RNA. They have the advantage of being able to use saliva as a sample, as well as swabs. Recently LamPORE has been deployed for local community testing in some locations. This test can be carried out in mobile laboratories around the country. LamPORE tests have high accuracy. They can be used for people with or without symptoms, but they are currently being deployed in the UK to detect people without symptoms in the community. As these tests are more accurate than lateral flow tests, positive tests do not require a confirmation by PCR.   Copied: Source https://www.rcpath.org/profession/coronavirus-resource-hub/guide-to-covid-19-tests-for-members-of-the-public.html    

Osteoporosis Medications, Action and Side Effects

May 25, 2019 3:40 pm

Recently I had a short live presentation on the subject of osteoporosis, osteoporosis medications, and the treatment options of this deteriorating bone condition. A patient who has had a bone scan may be diagnosed with Osteopenia and/or Osteoporosis. This information is usually conveyed by the forms of a Low T score. Both of these indicated demineralization of the bones, and the end result is  worsening of the bone structure. This leads to weaker bones and higher chance of fracture due to stress or trauma.

Treatment options should be approached is a global and systemic fashion. It is critical that the nutritional status is at its best possible and optimized for important healthy bone vitamins and minerals. Low protein needs to be corrected. Special attention should be given to nutrients, minerals and vitamins. These include ProteinCalcium, Magnesium, Vitamin D, and Vitamin K1/K2to name a few.

Healthy bones require ongoing and routine force in the form of exercise to remain health. Just as exercise improves muscle strength, it also improves bone health. Exercise is also critical in improving bone structure and density. Ideally, exercise should be weight bearing and resistance.  Examples include: hiking, walking, jogging, climbing stairs, playing tennis, and dancing. Resistance type exercise is weight lifting and resistance bands.  These exercise work by creating a pull or force on the bone either by gravity, movement or weight.  Always check with your physician before beginning an exercise routine, start slowly and building up to longer periods of time.  The ideal goal would be at least 30 minutes a day, every day, if you are able.

We frequently see patients immediately started on osteoporosis medications without checking or improving some of the nutritional markers noted above or without looking at exercise history. In some case, the medication recommended are contraindicated due to nutritional status.

The medications can be grouped in to those  that help with new bone formation (Anabolic agents) or those that help by suppressing the bone breakdown phase (Antiresorptive agents).

Groups of Medication

 

National Osteoporosis Foundation has an exhaustive list (below) of medications for treatment of Osteoporosis.

The table below outlines the side effects and mechanism of the actions of the common medications used for treatment of  osteoporosis which was published by the University Health News Publication on August of 2014.

Mechanism Of Action And Side Effects

 

With all this information, the few points to remember is that the most important factors in healthy bone structure are the nutritional status Protein, Calcium, Magnesium, Vitamin D, and Vitamin K1 levels.

This is an animation of normal bone Metabolism. It shows how bone structures is taken down and rebuilt continuously. This allows for a healthy bone maintainence as we age. The key is the balance of breakdown (osteoclast) and the build up (osteoblast) activity is regulated. Osteoporosis develops when there is more breakdown that build up.

With permission of Dr. Susan Ott of University of Washington.

Additional information available on her site.

Past blogs on Bone Health.

Gastric Balloon

March 12, 2019 9:10 am

Here we go again…. There is a new cure for obesity, Gastric Balloon, with minimal to no risk, is an outpatient procedure and/or can be done in the surgeons office with no anesthesia. Have we not similar claimed like this before (Adjustable gastric band) ?

Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss published  in Surgery for Obesity and Related Diseases 14 (2018) 1876–1889, by Sullivan et. al  reports

“Conclusions: Treatment with lifestyle therapy and the 6-month swallowable gas-filled intragastric balloon system was safe and resulted in twice as much weight loss compared with a sham control, with high weight loss maintenance at 48 weeks.”

This sound very promising, however is very vague and leaves out significant, critical, and pertinent information.

The outcome of weight loss at 24 weeks was reported in Total Body weight loss % (TBWL%), Excess weight % (EWL), weight loss, and BMI change. Of those, the last three were statistically significant changes.

The outcome the weight loss was reported to be at 7% TBWL% at 24 weeks with some weight regain, with the patient employing post REMOVAL life style changes.

It is stated that the Gastric Balloon is temporary device that needs to be removed in 6 months and should  be considered in low BMI patients (<35kg/m2).  It is is important for those patients who are considering this temporary expensive measure for minimal weight loss to entertain the alternative of the same temporary results that may be obtained by lifestyle changes. These results may be maintained by a healthy lifestyle, exercise, and eating without the need for a device.

2018 Back on Track

January 28, 2018 11:38 am

Join our 2018 Back on Track challenge and let’s get back on track for 2018! The holidays were wonderful but if you find yourself with a few extra souvenirs don’t feel alone. The average American gains between 1-8 pounds during the holiday season and I am no exception. Let’s get back on track 2018 together.

Time to clear out the kitchen! Disposing of temptations and high trigger foods is the first step to getting back on track. Throw it all away and don’t allow them back in. If foods are difficult to acquired then they are less likely to be consumed.

Stock up on high protein and whole, unprocessed foods that are low carbohydrate and nutrient dense. When quality foods are easily available we are more likely to stay on track with the types of foods we should be eating. Simple sugars/carbohydrates are the biggest culprit of holiday weight gain. We need to go back to the basics of hydration, high protein, low carbohydrate/sugar, vitamin/mineral supplements and exercise. Simple sugars and carbohydrates are easy for our bodies to use and absorb. Cutting them out can jump start your weight loss. Each individual needs to identify the daily carbohydrate intake that works for them. Some people stay under 50 grams of carbohydrates daily and some can tolerate more daily grams. You may also need to look at your protein and fat intake. All excess nutrients absorbed have the potential to turn into fat mass and inhibit weight loss. Metabolism video.

Hydration is an important ways to start getting back on track. Water is essential to life functions. The brain is 85% water, blood is 80% and muscle is about 70% water. Hydration aids in digestion, eliminating waste, byproducts and toxins. It also can decrease the feeling of hunger. Lack of hydration can increase fatigue which can lead to craving high carbohydrate foods to increase energy.

Protein’s importance in almost every bodily function and muscle mass can not be ignored. High quality complete Protein sustains muscle mass during weight loss, aids immunity, antioxidant function, and enhances leptin and insulin function. Filling up on protein first will help with carbohydrate carvings and give a sustained satisfied feeling. A prior blog post gives additional information on the importance of protein and the effects of protein malnutrition. WLS makes daily protein intake important but especially after Duodenal Switch, protein is a necessity of daily life.

Vitamins, minerals and supplements will ensure the body has the nutrients it needs to function adequately and can keep cravings at bay. Deficiencies in vitamins and minerals can cause cravings for foods. Vitamin and minerals are essential to muscle function, red blood cell production, bone health, and numerous other physiologic functions. We may all slack off on our supplements occasionally but now is the time to get back into the habit of daily vitamins and mineral supplements. A daily vitamin, mineral, and supplement routine is a lifetime commitment after Duodenal Switch or any WLS. Here is a list of commonly used supplements. If you haven’t kept up with your minimum yearly laboratory studies, now is the time to be seen and have your labs done.

Exercise can increase weight loss, overall well being, mental well being, mood, alertness, improve digestion, improve sleep, and increases energy levels. Exercise does not have to be a daunting task. Simply adding 15-30 minutes of activity can give added benefits. Yoga, walking, dancing, lifting weights, hiking, and sports activities can be included or added to more traditional forms of exercise. There are many free online videos for all types of exercise available. This year we are teamed up with The Kinesis Centre to offer a 4 week training program that can be accessed from anywhere. A 4 week training program will be included in our 2018 Back On Track Grand prize.

Finding a new hobby can keep both your hands and mind busy, curbing the unconscious eating of foods that are high in sugar and carbohydrates. Adult coloring books, drawing, painting, knitting, crocheting, sewing, dance lessons, gardening, learning to play an instrument and many others are great ways to use your time and expand your quality of life and brain function. New hobbies can also help establish new coping skills. Our previous post on Coping Skills After Bariatric Surgery can be found here. There are a whole host of online videos for “how to” on new hobbies.

back on track 2018 keshishian
2018 Keshishian BOT
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Teaming up with others can also help increase weight loss and compliance. Support from friends, family and other groups will assist you. There is a whole gamut of support group online and in person. If you have fallen out of the habit of attending our support group or webinars get back to them. You can find our schedule and announcements regarding webinars here. Our Central Valley Bariatric Facebook page also gives daily inspirational messages, protein recipes and articles and any new information or research available. There is also our Duodenal Switch Facebook Group. Anything that increases accountability is a benefit and motivates us to stay on track.

Experiment with new recipes and flavors that are bariatric friendly and within your dietary needs. There are so many options for quick and easy meals that are whole foods, high protein, and low carbohydrate. We have several recipes on our page for all stages following weight loss surgery and Duodenal Switch. However, there are endless option on the internet in Paleo, low carb, and high protein type recipes.

In the spirit of new starts and getting back on track 2018, we are having a giveaway with the basics to get back into the swing of things. This year we are looking for before and after weight loss surgical journeys for our Grand Prize. Share your weight loss journey! Don’t be shy, your journey can inspire others and/or motivate yourself. To enter the Back on Track 2018 Giveaway, please submit your weight loss surgical journey with before and after pictures to contact@dssurgery.com or you can also post your before and after pictures on our Facebook page. You will also need to sign a release for the use of your story on our website. We will draw 2 names from those that enter by announcing it on our FaceBook page or by e-mail on February 14, 2018. You must submit your mailing information to contact@dssurgery.com in order to claim the prize. You must be a verifiable patient of Dr. Ara Keshishian.

We are also doing 3 prizes of a 4 week training with the Kinesis Centre if you share an achievement picture on our FaceBook page . This achievement picture can be a milestone in your journey, something you’ve haven’t done before, a non-scale victory, a goal that you reached, anything that you are proud of achieving. Let’s do this 2018 Back on Track challenge!

Please remember that medications, health status, age, bowel motility, genetics, and diet all play a role in weight and weight maintenance. Please have a physician review your health history and medications.

*NOTE: Giveaway items may or may not be identical to the pictured items.
We are not affiliated with any of the products nor do we endorse any one type of product. There is no cash value to the prizes.