Tag: BPD/DS
Surgical Treatment of Gastric Fistula
August 05, 2015 7:45 pm
Alcohol and Weight Loss Surgery Webinar May 20, 2015
July 27, 2015 7:27 am
Shared Success Story- Andrea R.
July 22, 2015 8:00 am
Since I was about 10 yrs old I have struggled with weight. I was always the chubby kid in class, and as I got older I was always the chubby friend. Being overweight didn’t affect me until I hit 220lbs at 15 years old, and as you know, kids can be mean and hurtful. At 18 years old I had my first child, during that time I dropped a little weight then ended up gaining it back and more. At the age of 19 I was sitting at 250lbs.
Fast forward 3yrs, I had my second child and once again, I lost weight just to gain back double what I lost. So now, at the age of 22 I was up to about 290lbs. Every day life became a struggle. I tried my best to stay active, but being overweight made me tired and made me feel like hiding. Over those years I tried everything from low carb diets, to diet pills, to b12 shots, and Weight Watchers; you name it, I tried it. Finally, I was fed up! I couldn’t take it anymore and I was ready to look into different options. I was 26 years old, 5ft 8inches tall, and a mother of 2 who just wanted to be active and healthy for my kids.
I decided that weight loss surgery was what I needed to do. At this point I was morbidly obese and at my highest of 326lbs. I met with Dr. Keshishian, and after going through the consultation we decided the duodenal switch would be the best option for me. On August 26th, 2013, I had my surgery weighing in at 306lbs. Dr. Keshishian is amazing! I didn’t have any complications. I was able to drink and eat small amounts normally.
Since having the surgery, just shy of the 2 year mark, I am now down to 178lbs. My life has changed so much since losing the weight! I honestly can’t describe how grateful I am that I was able to have the surgery withScreen Shot 2015-07-20 at 1.55.13 PM such an amazing Dr. and staff. Anytime I had a question or concern they were willing to hear me out and do whatever they could to assist me. Since losing the weight I am able to be the active mother I wanted to be for myself and my kids. Now I’m taking the steps needed to ensure my kids learn healthy eating habits and helping them understand how important exercise is.
Andrea R.
Informed Surgical Consent
July 18, 2015 9:39 pm
Surgical informed consent is the document that summarizes the discussion that has been carried out between the treating physician and the patient. It also outlines the expectations as well as the potential complications of the treatment being proposed.
An informed consent should mean that the patient is absolutely clear as to the procedure agreed upon and that is reflected on the consent. No abbreviations are allowed on the consent forms. Clearly, there are instances when a physician or surgeon providing service may have to deviate from the proposed plan and agreed upon procedure on the consent because of unexpected findings in the operating room.
Any patient undergoing surgery should be acutely aware of the terminology and the language used. With regards to weight loss surgical procedures, RNY and GB is not acceptable because they are both abbreviations.
Duodenal Switch is a distinct well described procedure with its unique identifiable code (43845 for open procedure) that is recognized by hospitals, insurance companies and the surgical societies.
Duodenal Switch operation is not SADI, SIPS nor a loop Duodenal switch. Any attempt to interchanges these terms or operations is inaccurate the say the least.
A surgical informed consent is signed by the patient ( or the guardian) and the treating physician. This document however is reviewed and confirmed by all those involved in the patient’s care delivered in the hospital. The consent is reviewed by the admission staff when taking the patient for surgery, preoperative nursing and administrative staff, operating room circulating nurse as well as the anesthesia staff. One step most patients may not be aware is initiated after the general anesthesia is induced. The operating room staff, anesthesia staff and the operating physician all go through a set of checklist known as “Time out”.
“Time out” involves confirming the patient’s identification as well as the proposed procedure as the patient had discussed with the staff and confirming the consent.
It is imperative that a patient have complete understanding of their surgical options available to them and critical that they have full knowledge of the type of surgical procedure that has been consented to and performed.
Iron Deficiency & Anemia July 15, 2015 Webinar RecordingExclusive Member Content
July 16, 2015 1:52 pm
Vena Cava Filter
July 06, 2015 7:09 am
Example of a Vena Cava Filter Video:
Neuromuscular Disease After Weight Loss Surgery
June 08, 2015 11:30 am
Weight loss surgical procedures may result in varying degrees of nutritional deficiencies. Some of these nutritional deficiencies may cause neuromuscular disease if left untreated, these include vitamins, minerals, and protein. The long-term effect of these deficiencies may presents as neuromuscular conditions including, weakness, numbness, confusion and all others if not-diagnosed and untreated. It is important to note that all weight loss surgical procedures require lifetime vitamin, mineral supplements and protein monitoring and possible supplements.
The table below outlines some of the specific neurological and neuromuscular disease complications following bariatric surgery. The most common deficiencies seen with the duodenal switch operation are fat soluble vitamin deficiencies. These include, Vitamin A, D, E and K. Duodenal Switch patients need oral supplements of Dry “Water Miscible” type of Vitamin A, D, E, and K based on their laboratory studies and needs.
The neurological deficiencies are manifested much more frequently with the Gastric Bypass than the duodenal switch operation. The most common nutritional deficients are that of B1, B12, Folate deficiencies that are common in Gastric Bypass. A list of possible neurologic deficiencies and there associated symptoms were summarized by Becker (2012). Another article with Nutritional Neuropathies.
Nutritional deficiencies are seen in a number of illnesses including weight loss surgery patients.
Coping Skills after Bariatric Surgery
June 02, 2015 7:23 am
For many people, food can become a coping mechanism and a way to self sooth or comfort themselves. After weight loss surgery the ability to use food in this manner is disrupted due to the smaller portions and in some cases food intolerances. Developing alternative and healthy coping skills is an imperative step after weigh loss surgery.
Obesity is a multifactorial process that has many contributing aspects. Although, obesity is not entirely the result of poor eating behavior, and lack of exercise. After weight loss surgery, we should appreciate the importance of healthy dietary choices; being sure that volume and frequency is not driven by emotion or emotional eating.
The mental aspect of weight loss surgery should not be ignored. Developing healthy coping skills can be a large part of dealing with the changes that take place. Some people go through a mourning period for the loss of the foods that once gave them comfort, made them part of a group, or the feeling of their best friend. In some cases, there may be a need to seek the assistance of a mental health care provider to be able to work through some of the issues and feelings. Never hesitate or be afraid of contact a mental health care professional.
Learning and practicing effective coping/soothing techniques can be started prior to weight loss surgery. The following are some coping skills that can be effective for some to adopt into their daily lives.
1. Nature – Get out into the great outdoors and into the sunlight. The sounds and sights of nature have a way of energizing the body and calming the mind. Sunlight is excellent for increasing Vitamin D levels which can help elevate mood and general well being.
2. Exercise – The mental and physical effects of exercise are paramount after weight loss surgery. The natural chemical release from exercise is a calming effect and gives a sense of well-being. In addition, the physical aspects of increase weight loss and change in body contour have positive mental and emotional effects.
3. Music- There are many research articles regarding the positive effects on both metal and physical aspects of music. Music has a way of soothing or energizing the soul. Turn up loud or keep it soft. Sing along. Dance it out if you need to.
4. Journaling – We always suggest to people prior to weight loss surgery to start journaling. It can give you perspective when you look back at entries. We also suggest to journal body measurements, pictures, and weights so that you might look back at how far you’ve come from your starting point.
5. Mindfulness – Using all five sense to experience life and food. Take your time to take everything in and experience the full effect. Be present in all life experiences. Ask yourself: Am I enjoying this? Does this feel like what I need? Is this getting me to where I want to be? Is this healthy for me?
6. Support groups of peers- There is nothing like having a group of people who have been there or know exactly how you may be feeling to be able to talk, share or vent. There are so many support groups that can be taken advantage of in either face to face or cyber groups.
7. Treat yourself- Treat yourself and practice self-care by doing something that you find relaxing, gratifying or energizing. Massage, manicure, an outfit, shoes, an outing, or a class.
8. Distraction- Hobbies, new skills, reading, games, bubble bath, or anything that get you out of the same mental spot can help with calming and soothing.
9. Talking- There is great value in having a close friend or trusted therapist to be a sounding board and give you an opportunity to unload some of the challenges you’ve been carrying.
Changing habits and coping skills takes practice and patience. It is not something that is easily changed over night. Focus on small steps, goals and achievements. Give yourself time and credit for the accomplishments that you’ve made. Always look at how far you have come and the positive lifestyle changes you’ve made. There may be set backs but don’t beat yourself up about it, move on and continue to take steps toward your goal.
https://www.counselorlady.com
Vitamin D And A -Dry (Water soluble) Formulary
August 24, 2013 7:57 pm
Vitamin A and D are fat soluble vitamins. This means that in order for them to be absorbed by the GI track, them need to be absorbed by fat globules (chylomicrons). These are then taken up by the lymphatics of the GI track and taken to the blood stream. With the anatomical changes of the Duodenal Switch, the fat absorption capacity is significantly reduced. This results in excellent weight loss. It also results in much diminished absorption of the Fat soluble vitamins A, D, E and K. It is essential to use Dry Water Soluble forms of Vitamins A, D, E, and K. Bio-Tech is a brand that is formulated in this manner.
The Biotech D3-50 has 50,000IU of Vitamin D.
We recommend specific dosages of dry (water soluble) Vitamin A and D. These are not available at most pharmacies. In fact when our recommendations are presented at most pharmacies they are incorrectly dispensed with the fat soluble variety with is worth less becasue it is not absorbed by the duodenal switch patients. It is also important to not that this type of vitamin should not be taken with any dietary fat. Fat can inhibit the absorption of this type of vitamin. When ordering online, please make sure that the “Dry” or “Water Soluble” formulary is ordered.
