...The Information and Links Page

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Nutrition
Glossary
Surgery Comparison
Proximal
Distal
AGB
Duodenal Switch
WLS-History
Insurance Info
Finding Surgeons
Days to have Surgery
Question for Surgeon
BMI Calculator
Frame Type
Co-Morbidities List
Stop before Surgery
Water-up Surgery
Item to take to Hospital
Pouch Information
Vitamins You Need
Medicines to Avoid
Medic Alert Bracelets
Hair Loss
Grocery List
Hibernation Syndrome
Card for Eating Out

See the Surgery

 Nutrition - Good for Post-op, but maybe helpful upfront

See my Section on Nutrition - Protein, Fat, Carbs facts

 Food/Protein Counts - This is a table of foods and has Protein counts

Nutrition and Vitamin Facts - This is a pretty good search tool for Nutrition fact about food. It includes Carbs, Proteins, Fat and Vitamin data

FitDay  - This is a great free site about nutrition, weight loss, diet and fitness manager-

 Low Carb Cooking Recipes

 Largest Low Carb Store for Atkins Diet!

New => Good Calculator for Nutrition, Vitamins... "the whole enchilada "

Digestion and All about the Body - Great Site...  Tons of information

  Digestive System -  Colorado State University  - Good stuff

Pre-op Preparation

Glossary for WLS – This is a good link to a glossary of WLS terms                                       Top

Surgery Comparisons                     

Roux-en-Y -See my Surgery Page  - I chose this surgery because it has a pretty long history of success – 90% compare to others.  Also, I could find competent surgeons in my area.  I would have considered the DS, but surgeons are limited.

Proximal A proximal RNY patient has less than 150 cm of intestine bypassed.  Most RNY's are proximal.  The Proximal patient still has a mal-absorption of food and sugar, though to a lesser extent than a Distal patient.  The result is still weight loss, though it may be considered that the patient has less of a worry about mal-absorption of nutrition.  

Distal - This refers to the amount of stomach bypassed.  A distal RNY means that over 150 cm of intestine is bypassed - the section that processes sugar.  Thus the distal RNY patient does not process sugar and has a greater mal-absorption of food and nutrients.  The result is a more rapid weight loss, but a need for closer watch of nutritional intake.  An RNY patient may refer to their surgery as a "Distal RNY Fobi" procedure, or a "Distal RNY".  Distal RNY is usually reserved for patients with a weight exceeding 400 to 450 lbs.

Check this Site out for pretty good information about WLS

AGB – Adjustable Gastric Banding –  This is a newsletter article on the Pfamos site... good info.  Another site -

DS- Duodenal Switch - Good link, but may put down the Roux-en-Y.  I suggest finding a surgery that you can do with a good comfort level.

WLS - History Site  - Check this site out for a history of WLS and for WLS information

Gastric Bypass Family – Good Links to all kinds of WLS Stuff                                                         Top

New => Here is A Link to Watch the Surgery Actually Performed – Warning Graphic!

New =>Here is a link that has Excellent Illustrations step by step of Lap RNY-Laparoscopy.com

New => Great Site for All types of Calculators and Formulas- I used much of the info for writing my     calculator       -http://www.halls.md/

Insurance

Insurance is a pain and is one of the biggest concerns going into this process.  I had one insurance that denied me, HMO Blue of Texas.  I was lucky in that I had the opportunity to change insurance companies.  I chose United Health Care as a result of information found on this link.

Surgeons, Insurance and Hospitals in Your State that covers WLS

Surgeons and the Hospital that he uses in you area –

This is a link on Obesityhelp.com, but I have talked to many folks that did not know it existed.  I found it very helpful when looking for a surgeon.  I looked through these surgeons and where they performed the surgery.  I read the comments that people had made about the surgeon as well as the hospital.  I found Dr. Rodriquez in this list.  Both he and the hospital had excellent comments and ratings.  He was practicing in Palestine , TX at the time, but has now moved his practice to Dallas , TX .  I found him and the hospital to be exactly as had been noted in the lists.  He and the Hospital were excellent. 

I suggest that you go to this list and find a surgeon in your area. Find out what hospital(s) that he uses then research that hospital using the list below.

Surgeons, Insurance and Hospitals in Your State that covers WLS

Days to have surgery on                                                                                                                     Top

Though I did things a little differently, I have read where folks have problems sometimes with weekend staff.  So, if you have a choice in dates, pick a date that is during the beginning of the week to have the surgery. The staff that works during the week are usually appear on the ball while the weekend staff may not usually work on that floor. Though I had excellent nurses on the weekend, one of the weekend nurses told me that she doesn’t usually work that floor and may not be there the next day.  She was and I was glad because she was very attentive and nice.  Nice looking too I might add (But remember, I was on drugs).

Questions to ask you Surgeon

Here is a link to questions to ask your Surgeon

BMI and Body Frame
You will want to know your BMI/Body Mass Index before you go to your surgeon or even seriously look into this process.  BMI determines whether or not you can even qualify for the surgery, because it is one of the factors used by insurance companies to discern qualification.  Use the link below to access the calculator that I wrote. www.thinnerself.com/files/calculator.htm

Body Frame is used occasionally in this process.

Here is a link to help you decide if you have a small, medium, or large frame.  We big folks like to think we all have Large frames, but I found that I have a medium frame.

What Frame Size do you have?

Co-Morbidities List                                                                                                                          Top

      1.       Diabetes
2.      
Neuropathy
3.      
Hypertension
4.      
Family history of heart disease
5.      
Family history of stroke
6.      
Family history of Diabetes
7.      
Family history of heart attacks
8.      
Thickened heart walls due to weight/hypertension
9.      
Intracranial hypertension (psudeotumor cerebra)
10.  
Migraines/Headaches directly related to obesity/cranial hypertension
11.  
Bells Palsy
12.  
Cardiac Arrhythmias
13.  
Ocular Hypertension
14.  
High Cholesterol (hypercholesteralemia)
15.  
Elevated Triglycerides
16.  
Hypothyroidism
17.  
Excess Testosterone
18.  
Excess Facial & Body Hair (Hirsutism)
19.  
Acne
20.  
Rashes
21.  
Chronic Skin Infections
22.  
Excess Sweating
23.   frequent yeast infections
24.  
Hormonal Abnormalities
25.  
Infertility
26.  
Polycystic Ovaries
27.  
Dysfunctional uterine bleeding
28.  
Amenorrhea related to obesity
29.  
Incontinence related to obesity
30.  
Lower Back Pain and muscle spasms
31.  
Ankle/knees swelling
32.  
Asthma or Shortness of breath upon exertion
33.  
Decreased Exercise Tolerance
34.  
Hip pain
35.  
Sleep apnea and Heavy Snoring
36.  
GURD or Acid Reflux
37.  
Lack of Self Esteem
38.  
Social Rejection
39.  
Loss of Job Potential
40.  
Inappropriate Coping Strategies
41.  
Anxiety
42.  
Severe Depression due to weight, inability to exercise
43.  
Chronic Fatigue
44.  
Fluid retention
45.  
Gall Bladder removed due to weight and dieting
46.  
Activity Intolerance; shortness of breath and severe fatigue even with minimal activity
47.  
Decreased endurance limiting daily activities, including, but not limited to; walking, housework, working, dressing, standing, getting up, bathing, sitting, travel
48.  
Depression related to difficulty coping with frequent failures at diet attempts
49.  
Frequent constipation alternating with frequent diarrhea
50.  
Stress incontinence
51.  
Fibrocystic breast disease
52.  
Abdominal gas and frequent nausea
53.  
Hemorrhoids
54.  
History of colon polyps
55.  
Hip pain and joint pain
56.  
Varicose Veins

I found this list on a profile and thought it was good – Sharon Brittain

Stop taking these Items Before Surgery -  Check with your Surgeon                                                            Top

At least 1 week before surgery, stop taking all medicines which contain Asprin, or anti-inflammatory agents, such as Bufferin, Alka-Seltzer, Aleve, or Motrin.
Many surgeons require that you stop smoking before surgery.

Water
Drink at least 128 ounces of water starting two days before surgery.  Completely hydrating your body will help during the surgery and will help to keep you from being so thirsty following surgery.

I did this and did not get thirsty during my hospital stay...

Items to take to the Hospital
Toothbrush and the cloths you wear to the hospital...  Ok, that’s what I took and I was fine...I did have some toiletries and a change of underwear.  But, here is a list things that you may want to consider:

Bath robe
Slip on slippers (so you won't need to bend over)...  I did have these too
Small fan ... I got hot in ICU... they brought a fan to me, it was nice
Loose fitting clothes to wear home
Chapstick
Hairbrush, Toothbrush, Toothpaste, Deodorant, Lotion, Shampoo
Baby wipes
Antibacterial hand gel
CD player/headphone for relaxation and to block out noise
Ear Plugs
Magazines or books
Maxipads or feminine articles
Tongs or Wooden Spoons( this is to help reach places in the restroom) or here is a link to a tool made for that purpose... Bottom Buddy

Post-Op Items                                                                                                                                       Top

Pouch Information

Pouch Info -  Good information on Pouches: Mill-Peninsula
and Pouch Rules for Dummies

Determining the size of your pouch – Cottage Cheese Test

Vitamins

Daily Vitamin Intake Suggestion
*Multivitamin- like flintstones 2x a day or centrum chewables.
*Calcium Citrate with vitamin d - 1200 to 1500mg a day
*B-12 sublingual or injection- about 1000mg weekly
*Iron -about 25mg to 50mg a day. Make sure to take Vitamin C with it to help iron absorption. This is one thing to make SURE to get doctor advice on is the amount YOU should be taking of Iron if any.

http://www.centrum.com/multi/centrum_chew_label.asp - vitamins Chewable Centrum Vitamin link

Medicines to Avoid

MEDS TO AVOID AFTER SURGERY:
Meds to avoid post-op: "Always ASK Your Surgeon/PCP"

Advil, Alka Seltzer, Anacin, Ascriptin, Asprin, Befferin, Coricidin, Cortisone, Dolobin, Emperin, Excedrin, Feldene, Fioinol, Ibuprofen, Indocin, Meclomen, Motrin, Nalfon, Naprosyn, Norgesic, Tolectin, Vanquish, Aches-N-Pain Advill Tablets & Caplets, Aleve, Alka Seltzer, Alka Seltzer Antacid/Tablets/Cold Anaprox, Anaprox DS Anacin Tablets/Caplets/Max. Strength, Ancid Ansaid, Arthritis Pain Formula Arthritis Strength Tri-Buffered Bufferin, A.S.A. Enseals Ascriptin A/D Caplets, Ascriptin, Ascriptin Extra Strength Caplets, Asperbuf, Aspergum Aspirin - all brands including childrensBC Powder/Cold Powder Bufferin-Regular & Extra Strength Buffex, Buffinol Cama Arthritis Strength, Cataflam, Clinoril, Coumadin, Daypro, Disalcid Dipyridamole, Doan's Pills, Dolobid, Easprin, Empirin, Ecotrin Caplets/Tablets/Max. Strength, Excedrin/Any Type, Feldene, Fiorinal, Halfrin, Ibuprofen Ifen, Indocin, Lodine Magnaprin, Maprin/Maprin 1-B, Measurin Mediprin, Midol Caplet/200, Mobigesic Motrin, Nalfon, Naprosyn Norwich Tablets, Nuprin Caplets/Tabs, Orudis P-A-C Analgesic, Pamprin, Persantine Pepto-Bismol /Any Type Ponstel, Relafen Rimadyl, Sal flex, Ticlid Tolectin, Tolmetin, Toradol Trendar, Trigesic, Ursinus Inlay/Tabs Vanquish Analgesic Voltaren, Warfarin Wesprin Buffered, Zorpin

Pretty Good Link to Medicines to avoid, Ok, etc.

Medicines that are OK                                                                                                                     Top

Peri-Colace
Panadol
Tylenol
Tylenol Extra Strength
Gas-X
Phazyme
Colace
Dulcolax Suppositories
Fleet Enemas
Glycerin Suppositories
Milk of Magnesia

Medic Alert Bracelets/Necklaces                                                                                                 Top
 Ok this is an area that I thought there would be little or no controversy, but some folks say that you should have a bracelet/necklace and some folks say that you shouldn’t.  I don’t have one yet, but have considered getting one just to let EMT folks know that I have a pouch rather than a stomach.  They can decide on what kind of tube to insert where.  Here are a couple of the arguments:

1)     EMS Spoke on Medical WLS Bracelets Being Worn- "I keep seeing again and again on the websites and also in this last update, where people are confusing an endotracheal tube (which we EMT's use to provide an airway in an emergency) and a nasogastric tube, which goes into the stomach to suction unwanted fluids. An ET tube is nowhere close to long enough to do any damage to the pouch. My concern is that this could cause confusion in an emergency and contribute to a tragedy. The first aim for any EMS personnel is to protect a patient's airway, and sometimes intubation is the only way to do that. If it's a choice between death or hurting my pouch, I'll get the pouch repaired after the fact." And in response to that, a surgeon gave this reply: " Warren - Thanks for that clarification - you expressed my sentiments exactly - I think this medic alert is inappropriate - there is really nothing that should or would be changed in a life-threatening situation based upon someone having had a gastric bypass procedure."

2)     We should have medic alert bracelets to alert EMS of the fact that we have had the surgery.  It was stated that the stomach may have to be tubed to in an emergency and medical personnel could rupture the staple line.

Hair-Loss –Telogen Effluvium                                                                                                   Top

Some people find that they lose a lot of hair about 3 to 4 months after surgery.  This is pretty normal and is temporary. Another name for it is Telogen Effluvium.  Here are a couple of links concerning this problem.

Link 1 – Low Carb Luxury Newsletter   Link 2 -Dermnet

Grocery Items for few Weeks following Surgery

Protein Supplements (I use Adtkins, but try some before surgery)
Clear broth or bouillon (beef and/or chicken)
Crystal Lite
Carnation Instant Breakfast
Grits ( I ate a lot of Grits... enjoyed them)
Cream of Wheat
Malt O Meal
Sugar Free Popsicles & Fudgesicles
Sugar Free Jell-O, Sugar Free Kool-Aid
Cottage Cheese
Eggs (soft scrambled) Some people have a hard time with eggs
Tofu
Cup of Soup

 

Hibernation Syndrome-                                                                                                                        Top
This is something that I dealt with for 3 or 4 weeks.  The first 3 weeks I had all kinds of energy, but about week 4 I got really tired, fatigued and wanted to sleep a lot.  I also found that I was quite depressed.  At night, though I would have insomnia.  I found out that this is Hibernation Syndrome.  This happens because of the stress of surgery, but also because of the low amount of calories that you are digesting.  Your body goes into this because it thinks you are starving or in a famine and tries to conserve energy.  The last thing that you want to do is exercise, but this is the best thing for you.  Exercise make your body think that you are hunting for food and gives you a boost... at least this is someone’s theory... but sounds good.  Here is a link to Hibernation syndrome.



Diet Card For Eating Out  -This is a good idea... maybe for eating out or at buffets

See the Actual Surgery - This Link takes you to a site to actually see the surgery. Warning! This is surgical video.

Good Animation of Surgery -  For the Faint of Heart :-)  This is a good animation that shows what they do in a RNY.

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