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Category: Duodenal Switch

Medications that negatively affect bone loss and contribute to Osteoporosis (Moved)

March 31, 2015 4:07 pm

An Example of Medications that may cause bone loss

Medications that negatively affect bone loss and contribute to Osteoporosis (Moved)

It should be noted that this list is NOT all inclusive and gives the type of medication but does not list all the medications in that category that may affect bone health. I would also like to point out that the Proton Pump Inhibitor labels should probably be changed to “Acid Reducers” as reducing acid is the issues. https://americanbonehealth.org

“Obesity Docs Should Consider Duodenal Switch”

March 10, 2015 3:10 pm

Obesity Doctors Should Consider Duodenal Switch

by Dr. Ara Keshishian

Shared Success Story- Brad P.

January 29, 2015 9:53 pm

From Fat to Fine – Becoming half the man I used to be!

I started life big – 11lb 13oz to be precise. From that point, I just grew.

I was the tallest and biggest kid in my class. I was picked on for my size, but I learned to live with it. Growing up on a farm, I was active, but never at a loss for a big meal and good food. Couple that with two war brides as grandmothers, I always cleaned my plate.

I graduated high school well over 350lbs, but at 6’6” I wore it well. Then before I knew it, I found myself over 450 lbs through most of my 20’s. I knew this was not sustainable, and albeit I was healthy overall, I tired easily, and wasn’t able to do the things that I used to be able to do. Everyone told me that I ate too much, and I felt that I was constantly watched whenever I would order food.

I tried everything… I went to the gym five days a week for an hour and a half… lost 12 lbs over 6 months. Did every diet imaginable- Slimfast, Medifast, Adkins… Even entertained bariatric surgery once in my mid 20’s, but I just saw too many people gain it back afterwards. During this time my weight fluctuated, and my doctor kept on telling me it was because I ate too much. Was this the case when I spent six months eating 1200 calories a day? I think not.

Fast forward to being 495 lbs at 28 years old with a new baby and diabetes on the horizon. Through researching various options available to me, I learned about the Duodenal Switch. My wife was interested as well, since she spent most of her life in the same boat as me. As we researched it, we couldn’t believe that the chances of regain were much less compared to other weight loss surgeries and with the fact that I would be able to partake in the foods that I loved (in moderation of course) post recovery almost confused me. Could this be real? You mean I can eat bacon and meat and the normal things that I grew up on in moderation and still be healthy? This can’t be true!

I met Dr. Keshishian through a local support group. On his advice, I met with other doctors who performed the same procedure, but I came right back to him. My wife had her surgery performed June of 2013 (You’ll learn about her soon) I had mine six weeks later on July 22^nd. Eleven months later, I went from a size 54 waist and 5x shirts to XL Shirts and a 38 waist. But that’s not the most important part. I’m healthy. I have the energy to chase my three year old daughter around, and for once in my life, I finally feel like I’m part of the group. If you are in a position to lose a great deal of weight, the Duodenal Switch is the ONLY way to go.

Surgery Weight: 485

Current Weight: 265

Brad P.

Bakersfield, CA

Congratulations Brad on all your success and weight loss! You have accomplished a remarkable transformation!

Nearly 16 years Post DS

January 29, 2015 3:24 am

I was recently lucky enough to be able to have dinner with my first private practice Duodenal Switch (DS) patient from almost 16 years ago. This DS journey has been amazing, enlightening and humbling. I am continually impressed with how people change their lives and go on to exceed their own expectations. It was wonderful to see my rationale for promoting DS as the weight loss surgical procedure with the best long term outcomes and “normal” eating ability perfectly represented. Patient #1 has maintained her weight loss long term, ate the variety of foods served at about 50% of what others around the table ate and has continued to thrive in her life. Our meal consisted of protein, vegetables, rice and even a bit of dessert. She runs a company with numerous employees and interacts with clients on a daily basis. She has maintained her laboratory studies with consistent daily protein, vitamin and mineral supplementation. She has not needed iron infusions or any other additional nutritional support. There are many misconceptions out in the bariatric and general community regarding the DS. DS patients do not normally have accidents, have an odor about them, or spend all day in the bathroom unless they have eaten something that does not agree with them. Nor is weight loss surgery an easy way out. It is a lifetime commitment of protein, vitamin and mineral supplementation with yearly laboratory study surveillance. I have always believed that giving the patient the most “normal” eating ability with long term weight loss success is the best outcome. Dr. Bruce MacPherson was my mentor in Pontiac, Michigan where I learned Hess technique for DS. Dr. MacPherson was personally trained by Dr. Douglas Hess. My private practice experience with DS started in 1999. I truly believe that Hess technique gives the best overall outcome and lifestyle to the patient. In my opinion, the Hess technique is comparable to taking normal anatomy and reducing it down to overcome metabolic disruption. The above is an example of one patient’s outcome. Each patient’s experience is individualized based on their health history, anatomy, metabolism and surgical outcome.

2015 Back on Track or A New Start after Weight Loss SurgeryExclusive Member Content

January 08, 2015 8:37 pm

Hernia Repair And Weight loss surgery

December 22, 2014 3:35 pm

Patients having weight loss surgery (WLS) either primary or revision are sometimes also diagnosed with having a hernia. Whether a hernia can be repaired concurrently with WLS or not, depends on the type of the hernia and also type of weight loss surgery.

The 2 most common hernias encountered in weight loss surgical patient’s are 1.Ventral (incisional), or 2. Hiatal hernias. Ventral hernia refers to defects or weaknesses of the abdominal wall. If this involves a previous midline incision then an incisional hernia is diagnosed. These hernias may present with any or all of the following findings; protrusions or bulging of the anterior abdominal wall tissue through the abdominal muscle cavity, abdominal pain, and nausea and/or vomiting.

Hiatal hernias are located inside the abdominal cavity at the junction of the esophagus and the stomach at the level of the diaphragm. This condition is where the upper portion of the stomach this is usually located in the abdominal cavity has migrated through the esophageal hiatus into the chest cavity. These hernia’s usually present with reflux, episodes of nausea and are quite frequently seen in patients with experienced complications of the LAP-BAND.

The surgical treatment of these hernias are very different:

Ventral hernia repairs may require mesh placement. There are different mesh products that are available. Some are made with non absorbable material and other are absorbable- biologic material that last long enough to allow incorporation by the patients own tissue. In general, when a mesh is used, the incidence of hernia recurrence goes down significantly. However, there is an increase in complications associated with the use of mesh. These may include infection of the mesh, indications of synthetic material, and serum and rejection indications of non synthetic material. To add another layer of complexity, when the hernia is encountered at the time of weight loss surgery, especially when the GI track has to be opened ( in the case of duodenal switch, revision from a failed gastric bypass with a duodenal switch) then it is recommended that no mesh be placed because of the high incidence of mesh infection or the associated complications. In extreme cases where the abdominal wall cannot be closed, biologic meshes may be used with the understanding that a repeat hernia repair may be required at a later date.

In my practice, Hiatal hernias are always repaired at the time of the weight loss surgical procedures. Depending on the type of the weight loss surgery the patient has had previously, the type of the hernia repair, and whether or not a mesh needs to be utilized, and the amount of stomach and fundus remains for the repair, will dictate how the Hiatal hernia is repaired.

Additional information regarding hernias in a newsletter.

Holiday Survival Tips by: Marylin Calzadilla, Psy.D.

November 17, 2014 8:23 pm

The holidays are almost here, and it’s a time of year that traditionally involves spending much time with loved ones as well as engaging in one of America’s greatest pastimes, eating. For the most people, holiday memories are strongly tied to traditional dishes and treats – turkey and ham, stuffing, mashed potatoes, and pie. But for those who have had weight loss surgery, or even if you are simply trying to be conscious of your health and weight, it is important to step back and think about the holidays from a different perspective. Below are six ideas not only for survival but for success this holiday season.

REFLECT

Think about what the holidays truly mean for you, and take the time to ask yourself what you want from this holiday season. Most of us get caught up in the rat race and never really stop and think what it’s all about. Vast amounts of money are spent on marketing campaigns aimed at luring us into shopping malls and grocery stores to buy the “indispensable” items of the holiday. Rather than get caught up in the hustle and consumerism of the season, I encourage everyone to stop and ask themselves what they’re truly wanting from the holidays. For some it may be spending time with those they care about, for others it may be to take time for oneself. Write down your goals on an index card and post it in a prominent place at home or at work as a reminder of what your holidays are going to be about this year.

SUPPORT, SUPPORT, SUPPORT

Tap into your support network. We know that strong, available support networks are key to long-term weight loss success. Often we are afraid to ask for help as if requesting assistance were symbolic of weakness. Often we have a double standard when it comes to support. We like helping others yet dislike asking others for help. Just as it feels quite rewarding to help someone that you care for, let the individuals in your life be there for you. Allow yourself to talk about your feelings, share your experiences, both positive and negative. There is also no better time to attend support group meetings. You can gain extensive comfort being around those facing similar issues. You can also learn from their mistakes as well as their successes.

ALLOWANCES

It’s difficult to achieve success if you feel deprived all the time. You may want to think about the dishes that are truly special to you and allow yourself to consciously indulge in a treat, if it’s appropriate for your level of post-operative diet. If you look forward to Aunt Marie’s delicious sweet potato pie every Thanksgiving, then allow yourself to enjoy this once-a-year tradition. Don’t tell yourself you will never be able to eat your favorite foods again. The bottom line is that long-term success with weight loss is about quality and quantity. Allow yourself to savor each and every bite, and remember portion control. Also strike a deal with yourself to manage any extra calories you’re taking in with increased exercise or careful eating on other days.

KEEP ACTIVE

Make a realistic exercise plan and stick to it. It’s easy to forego exercise during this busy time of year, but you shouldn’t compromise on your health. You will be spending more time around food and probably consuming a little more than you typically do. Sticking to your exercise routine will help you to indulge without feeling guilty and will allow you to get through the holidays without losing your hard-won progress on your weight loss. Plus, exercise will help you keep your energy and endorphins up so you can get everything done and feel good while you’re doing it.

CREATE

Spend some time researching new bariatric friendly recipes. You might actually really enjoy the process, and it’s also an opportunity to introduce some healthy alternatives to friends and family. The truth is, everyone is thinking about smart food choices these days, and people will appreciate a tasty, healthy alternative to the usual holiday fare. At the very least if you prepare a nutritious side or appetizer for a social gathering, you’ll know that there will be at least one healthy dish for you to eat.

PLAN ACTIVITES

Most holiday time is spent around the kitchen and the dinner table, but don’t be afraid to change it up. Create some fun activities your guests can engage in. Some friends of ours host a karaoke contest after their Thanksgiving meal. Other families go out for a walk, play charades, or even have contests on the Wii, Xbox, or any other home gaming system. Don’t be afraid to create a new tradition that gets everyone laughing, moving and having a good time.

Integrating some of these ideas can help keep you, your goals and the holiday season on track, healthy, and happy. All of the above tips may need to be adjusted depending on your situation and post surgical status.Best Wishes,
Marylin Calzadilla, Psy.D

Shared Success Story: Krystal U. Had a LapBand to Duodenal Switch Revsion

November 13, 2014 6:23 pm

Another amazing and emotional success story by Krystal Unruh. Krystal we celebrate you and your successful LapBand to Duodenal Switch revision. Thank you for sharing with us all.

Shared Success Story: Patricia Y. Had a LapBand to Duodenal Switch revision

November 04, 2014 3:16 am

Patricia’s success story is truly inspiring and emotional. Please take a moment to celebrate her success by watching video about her journey and revision from LapBand to Duodenal Switch. Thank you Patricia for sharing you journey with us.

Patricia Y.

Laboratory Blood Specimen Collection Change

October 30, 2014 5:20 pm

picture of blood specimen tubes — Older and Newer Blood Specimen Tubes

No one likes surprises at the lab when you are about to get your blood drawn. The picture above is of the older vacutainers blood specimen tubes and a new type of tube that is being introduced. There is currently a change over of blood specimen tubes in laboratories across the country. Locally we are seeing the use of SARSTEDT tubes/syringes. This change over is for several reasons. First and foremost is to reduce blood bourne pathogen exposure due to needle sticks and tube breakage. However, these blood specimen tubes offer some additional benefits, especially to people who frequently have lab draws. One of which is the ability to use aspiration of the specimen to decrease the incidence of hemolysis. Hemolysis skews laboratory studies and damages the red blood cells in the collected specimen causing the need for repeated testing. Aspiration is also easier on fragile veins due to the decrease pressure versus vacuum. The SARSTEDT tubes are versatile in that they can also be used as a vacuum tube if needed.

Hope this knowledge will alleviate at least some anxiety on your next trip to the lab for your blood draws. Remember that follow up laboratory studies after weight loss surgery is a lifetime commitment that ensures your health and adjustment of vitamins and supplements.