Bariatric Weight Loss Procedures and the Names They Go By

It's Back to School week here at LivingAfterWLS! I love this time of year - new starts, refresher studies, and back to the art and craft of learning. Yesterday we reviewed the Four Rules of bariatric weight loss surgery. Today, for anyone considering weight loss surgery, for new patients or veterans of surgical weight management I present a brief review of the currently approved surgical procedures and the names they go by.

By Kaye Bailey

The advisory committee for the 2010 Dietary Guidelines for Americans reported grim news earlier this year when they confirmed that currently about two-thirds of American adults and one-third of American children are overweight or obese. The committee warned that Americans must slash their caloric intake and increase physical activity because the obesity epidemic is "the single greatest threat to public health in this century."

Given that discouraging news nearly 300,000 adult Americans will undergo bariatric surgery this year as a means to losing weight and treating chronic morbid obesity. There are at least 35 bariatric surgical procedures approved by the Food and Drug Administration (FDA) for the treatment of obesity. While each procedure is unique they are all generically referred to as Weight Loss Surgery (WLS). The American Society for Metabolic and Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change:

Restrictive procedures that decrease food intake with the use of stapling or banding.
 

Malabsorptive procedures that alter digestion causing food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

Patients seeking surgical help for obesity quickly learn the nomenclature of bariatric medicine and can readily list the names by which different surgical procedures are known. Bariatric procedures are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure, according to the European Association for Endoscopic Surgery, should be tailored to the individual situation. Here we look at the most commonly performed bariatric procedures in the United States and learn the names they go by:

Gastric Bypass Surgery: Since the early 1990s gastric bypass has been the most commonly performed surgical weight loss procedure and the laparoscopic gastric bypass is considered the "gold standard" of bariatric surgery. The public at large often mistakenly calls all bariatric procedures gastric bypass. Gastric bypass is both a restrictive and malabsorptive procedure. Patients refer to it as WLS, GBS, Roux-en-Y Gastric Bypass (RYGB) or simply gastric bypass.

Adjustable Gastric Banding: This procedure, most commonly called lap-band, is restrictive with the use of a prosthetic band placed around the upper part of the stomach, much like a belt. There is no cutting or stapling of the stomach. A tube is connected to the prosthetic band to a small access port that is fixed beneath the abdomen skin. The band is adjusted through this port to help control weight loss outcome. Patients call this procedure banding, lap-band, or gastric banding. They refer to themselves as "Bandsters" or "Bandits".

Sleeve Gastrectomy: This is a purely restrictive procedure meaning there is no intestinal bypass. The sleeve gastrectomy is rapidly emerging as a reasonable alternative to adjustable gastric banding and other stapling procedures with patients favoring it over the malabsorptive procedures. Among patients the procedure is often called "gastric sleeve" or "the sleeve" and patients of this procedure refer to themselves as "sleevesters".

Laparoscopic vs. Open Procedure: Laparoscopic procedures are used for a variety of general surgeries and in the last decade have become the predominant technique for many surgical procedures. When a laparoscopic operation is performed a small video camera is inserted into the abdomen through small incisions made in the abdominal wall. The surgeon views the procedure on a separate video monitor. Laparoscopic procedures are considered less invasive than open procedures that require one long incision to open the abdomen. Studies indicate patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels. In addition laparoscopy patients have fewer wound complications such as infection or hernia, and they tend to return to quickly to pre-surgical levels of activity.

Kaye Bailey (c) 2010 - All Rights Reserved

To learn how to make the most of these procedures,
take a look at this featured article from the  5 Day Pouch Test website:

Three Keys to Lasting Weight Loss Surgery Success 

Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery.  Read more

The Lies & Myth of Goal Weight

LivingAfterWLS Weekly Digest
May 10, 2011

Today I'm addressing goal weight as it relates to our experience with weight loss surgery. Prior to surgery patients are in cahoots with their surgeons as they plan for bariatric surgery, set the course and denote the finish line which will be crossed when goal weight is achieved. I don't particularly like to hear what I'm about to say and I know it is a tough thing for my WLS Neighbors to hear, but I'm putting it out there bluntly so we can face it and take action:

Few patients will ever reach goal weight.

There you have it. Numerous studies suggest that fewer than 20% of patients achieve goal weight. My work with patients of all gastric surgeries for weight management suggests the same thing. In fact, it is fairly common for me to meet someone who introduces themselves saying, "I'm one of those people who never made it to goal weight." Here is what you need to know about goal weight so it will cease to be a barrier to your pursuit of overall health.

Know This Truth:
It is the random method of determining goal weight that is flawed; it is not the patient who is flawed.

Goal weight is a random data point set arbitrarily with reference to standardized tables that are irrelevant to an individual's health history, age, co-morbidities and genetic profile. In most cases the goal weight creates unrealistic expectations for the patient. When patients do not achieve this random point of measure called goal weight they consider themselves a failure and "one of those people." Patients become hopeless and frustrated. These feelings almost always lead to rebound weight gain.




Why do we use weight as a measure of health?
From the time of our birth when proud parents happily announce our weight and height and throughout our life these two data points (weight and height) are used to assess our health. The reason? Cost and convenience. Collecting these two measurements is easy and cheap. Most medical professionals agree that the current standards for body weight measured by weight in relation to height (called BMI-Body Mass Index) does little to reflect disease risk, identify body fat, and in general presents a misleading argument for overall health. In reality, the most these data points reveal is change without indicating a decline or improvement in health. Yet we are encouraged with weight loss surgery, and by conventional diet programs as well, to focus on a goal weight that may have very little to do with the health of our body.




Today we go beyond goal weight to help you achieve better results that are health focused.

Please join me with an open mind as we look at goal weight as it is used by weight loss surgery patients. Bear in mind that I'm not anti-goal weight. I am simply sharing the knowledge I have collected in building my understanding of how such a tight focus on goal weight results in difficulty and disappointment for many patients. As you read with an open mind add this knowledge to your personal experience and understanding. You are a powerful person. Harness your strength and intelligence as you engage in the pursuit of  better health and better living with weight loss surgery.

This is a longer newsletter than our normal weekly digest. I know we are all limited on time and asking you to read this may be a burden. But the content here is very important to your life-long healthy weight management. I hope you find it worth your while. 

Happy Spring - We are all in this together!

Kaye

KayeBailey@LivingAfterWLS.com

Read the full newsletter - Free Download Worksheet

LivingAfterWLS Weekly Digest: Refresh You WLS Menu

One of my favorite things about spring is the variety of fresh berries and vegetables that come to the markets. After a long winter of cooking from the pantry I welcome the light freshness of asparagus and strawberries and baby lettuce and such. There is just something about this time of year that renews my interest in cooking. Today in the digest we spend a few moments refreshing our memory on how to find a good Day 6 recipe that supports our healthy weight management goals. The more we work toward being masters over what we cook and how we cook the more successful we can become at managing our weight and hopefully improve the health and nourishment of those we love.    

Happy Spring - We are all in this together!

Read the newsletter online in our archive: Digest April 13, 2011

I'm Freezing! Why are we so cold after weight loss?

Happy Groundhog Day everyone! Temperatures across North America today are ridiculously cold! Are you staying warm? After significant weight loss many of us struggle with body temperature regulation and truly suffer when cold weather hits. There are some very good biological reasons for this - take a look:


I'm Freezing! Why are we so cold after weight loss?
Body temperature is the result of your body generating and radiating heat. The body is adept at keeping its temperature within a narrow range even though ambient air conditions vary. A normal body temperature is 98.6°F. It is common during the period of rapid weight loss for bariatric patients to feel cold or chilled, even when their temperature reads normal.

People who experience the massive weight loss associated with weight loss surgery experience feeling cold for two reasons: loss of insulation and less energy generation.

Fat is a highly efficient insulator. Consider animals native to cold climates: for example sea lions and polar bears. They are loaded with insulation and thrive in cold climates. When gastric bypass patients follow the rules: eating protein and exercising, the weight lost can only come from fat or stored energy. In effect you are losing your insulation. Less insulation increases the likelihood that you will feel cold.

The second reason for feeling chilled is that the metabolic cell processes are not working as hard as when you were heavier; it takes fewer calories and less energy to maintain and move a smaller body. Think about using an electric mixer: if you are whipping egg whites for a meringue the mixer will do this task effortlessly. But use the same mixer to knead bread dough and it will become warm to the touch, it is working harder because it is moving more mass. The same thing happens with your body; the more mass it must move, the harder it works. As a result more heat is generated.

The body has two well-tuned mechanisms for regulating body temperature: sweating and shivering. What overweight person hasn't been embarrassed by a sticky bout of sweating at the most inappropriate time? Sweating is a mechanism for cooling your body when it becomes too hot inside. The body rids itself of excess heat by expanding the blood vessels in the skin so the heat may be carried to the surface. When this energy or heat in the form of sweat reaches the skin's surface it evaporates and helps cool the body.

Gastric bypass patients become more familiar with the second temperature regulator, shivering, as they lose weight. When you are too cold your blood vessels will contract reducing blood flow to the skin. The body responds by shivering which creates extra muscle activity to help generate more heat. If you allow your body to shiver it will begin to feel warmer. But this is also a good clue that it's time to put on a sweater or turn up the heat. I think most weight loss patients will happily wear a sweater - a sweater is much easier to shed than that insulation we've worked so hard to lose!

Most weight loss patients report that their body temperature regulates after their weight is stabilized, usually eighteen to twenty-four months after surgery. Keep in mind your body is rapidly losing weight and the rest of your body's functions are caught off guard when this weight loss begins. The body's thermostat needs time to catch up to the weight loss, and it will. Patients who incorporate exercise in their weight loss program experience less chilling than patients who do not exercise.

Copyright © 2005 Kaye Bailey - All Rights Reserved

Article Source:  I'm Freezing! Why Gastric Bypass Causes Patients to be Cold

Getting Party Ready with Your WLS Tool

I wrote this article for the 5 Day Pouch Test Bulletin published 12/06/2010. For anyone with weight loss surgery who is preparing for a holiday party the advice is timely. I think it defines so well what many of us say our new objective is after weight loss surgery --- to enjoy LIVING!

Not so good conventional advice...

Eat a small meal before the party I'm sure you are familiar with this holiday tip - eat a small meal before the party so you do not overeat at the party. Since all of our WLS meals are small this is ineffective for us - it just means we double-up on small meals that day. What works better is to have an all-protein meal earlier in the day, before the party. For example, if the party is at 7pm have an all-protein lunch of grilled chicken breast at 4pm; about 3 ounces of broiled boneless chicken breast gives you 110 calories (energy) and 25 grams of protein with only 2 grams of fat. This is important because it temporarily raises your metabolism by making your body work harder to digest the food. Protein also satiates appetite for a longer time than carbohydrates. In addition, with protein you have not caused a drop or spike to your blood glucose levels which for many triggers snacky carbohydrate cravings. On a more delicate note, clean lean protein is unlikely to cause digestive distress such as uncomfortable bloating or gas - two things we do not want to wear to the party! Keep in mind as you are preparing for the party that the goal is to arrive at the party in the very best state of biochemical balance possible so you can enjoy the people, the setting, the entertainment, and the total party experience. You can best do this by following the Four Rules and Liquid Restrictions in the days and hours leading up to the party. It is a privilege to attend a party in a state of balance and good health, a privilege worth the effort, a privilege you deserve to enjoy! After giving your body the delicious protein-only lunch allow it time to digest the nutrients before partaking of liquids. A good hour following eating is beneficial to allow your body adequate time to metabolize the fuel you have just provided it. After digestion hydrate your body with a nutrient enhanced beverage. This could be herbal tea or iced water with a squeeze of fresh citrus juice. Perhaps you prefer an energy booster such as Emergen-C (my favorite). Avoid beverages sweetened with sugar alcohols because they are prone to cause uncomfortable gas and bloating. OK! You've done great getting your body ready for an evening out celebrating the holidays. But do you realize what else has occurred by doing these simple things? You have created a storm of empowerment where anything is possible! Think about it. Instead of spending the day of the party making poor dietary choices for which you are feeling self-critical, you have done the right thing! You have been true to yourself and your health! Nothing is impossible for you on this day! So go that party and shine like a diamond. Accept the compliments you receive - relish in your new life - Celebrate! This is your moment - You Have Arrived!

Weight Management with Weight Loss Surgery

Three Red Flag Warnings Leading to Weight Gain After Bariatric Surgery
Before undergoing bariatric surgery for weight loss it is hard to imagine that we could possibly ever become one of "those people" who gain weight after losing it with the help of surgery. Sadly, at some point most patients who have gastric surgery as their last hope for weight loss eventually regain some weight back. It can happen quickly and without fanfare. Link here to learn about three red flags to watch for that may lead to weight regain.

Capture regain with 5 Day Pouch Test

Understanding the Liquid Restrictions of WLS
Liquid restrictions are imposed on patients of all bariatric procedures including gastric bypass, adjustable gastric banding (lap-band) and gastric sleeve. For thirty minutes prior to eating and thirty minutes following eating patients are to abstain from drinking fluids. They must not partake of liquids while eating. Learn why liquid restrictions play a key role in weight loss for bariatric patients. Read Full Article

Restrict Liquids, Drink Lots of Water - HUH?
Making Sense of WLS Guidelines
In a country where food and drink go hand in hand weight loss surgery patients are challenged to follow the liquid restrictions as instructed by their bariatric center. But understanding and following the liquid restrictions plays a key role in long-term weight maintenance following gastric bypass, gastric sleeve, or adjustable gastric banding (lap-band) surgeries. Learn more

New Articles from LivingAfterWLS

Three Red Flag Warnings Leading to Weight Gain After Bariatric Surgery
Before undergoing bariatric surgery for weight loss it is hard to imagine that we could possibly ever become one of "those people" who gain weight after losing it with the help of surgery. Sadly, at some point most patients who have gastric surgery as their last hope for weight loss eventually regain some weight back. It can happen quickly and without fanfare. Link here to learn about three red flags to watch for that may lead to weight regain:

Three Benefits of Checklists in Successful Weight Management With Weight Loss Surgery
People who undergo surgery for weight loss are often tempted to simply let the surgery do the work for weight loss without making an effort to adapt new healthier diet and fitness habits. But the surgical bariatric patients who wish to achieve weight loss and maintain a healthy weight for years to come will use the surgery as an opportunity to form new habits creating a new healthier way of life. Read full article

A Weight Loss Surgery Journal Marks Progress and Healing
We have heard it all our dieting life: "keep a food journal, it will keep you accountable for what you eat." That advice always failed me, the best I could ever keep a food journal was through breakfast, I did not want to leave written evidence of my eating behavior. But there is one time in my life I kept a journal, words and feelings scribed on the page. Read more:

Make Grilled Fish a Healthy Part of Your Weight Loss Surgery Diet
Since weight loss surgery gives us a second chance of leading healthy lives it behooves us to pay attention to what we eat and incorporate things in our limited diet that can aid our health and longevity. Fortunately for us one of the healthiest things we can eat is also weight loss surgery friendly: Fish. Learn more.

Grilled Lamb With Provence Herbs and Summer Vegetables
For people following a high protein diet, such as weight loss surgery patients, grilled lamb is an excellent protein source that is low in fat and rich in minerals and nutrients. Marinating the lamb early in the day before grilling yields a flavorful and savory protein the whole family can enjoy. Article & Recipe Here

Hot Off the Press!

Apples and Exercise Promote Body Fat Loss After Weight Loss Surgery
For some exercise enthusiasts carbo-loading is key to supplying the body with adequate energy for extreme workout sessions. But for the rest of us the simple apple may be the best carbo-loading secret around when it comes to supplying the body with energy before a workout. Read More

Three Keys to Lasting Weight Loss Surgery Success
Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery. Bariatric surgeries help arrest the disease by reducing the amount of calories a person may eat, but the surgery does not remove the disease. With patient compliance weight is lost and obesity can be put in remission.
Read more

Dietary Sensibility Prevails Even With Weight Loss Surgery
Even though the standard for pre-surgical education has been elevated for bariatric patients seeking treatment for obesity with weight loss surgery a certain silliness prevails among both patients and the public suggesting surgery is the easy way to lose weight and lifestyle changes are not necessary to affect weight loss. The notion that simply eating less of the things we were eating at the height of our obesity as a means to losing weight is absurd. Read more

Weight Loss Surgery, Vegetarians and High Protein Diet - Putting it All Together
Vegetarians who are suffering from morbid obesity and undergo weight loss surgery for the treatment of obesity are challenged to follow the weight loss surgery high protein diet when they do not partake of red meat, poultry, fish, or seafood. The first rule of a bariatric diet is to eat protein first: at least 60 percent of dietary intake should be protein. Low glycemic carbohydrates and healthy fat provide the remaining 40 percent dietary intake. Read more

Three Keys to Lasting Weight Loss Surgery Success

By Kaye Bailey

Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery. Obesity is not a simple cosmetic problem of excess body weight than can be corrected with surgery. It is a metabolic disorder where the body stores an abnormal amount of body fat. Bariatric surgeries help arrest the disease by reducing the amount of calories a person may eat and some surgeries reduce the amount of nutrients the body absorbs and stores as fat. The surgery does not remove the disease but with patient compliance weight is lost and obesity can be put in remission.

Chances for healthy weight loss and weight maintenance with surgery can improve with patient commitment to recovery. Patients must accept that the burden of treatment for their disease obesity is with them. Bariatric counselors tell patients the surgery is only a tool and it is up to the patient to use it correctly. This applies to all procedures including gastric bypass, gastric sleeve, and adjustable gastric banding (lap-band). There are three pro-active things patients can do to use their tool wisely:

Lifestyle: Accept that bariatric surgery brings with it an entirely different lifestyle that you must adopt for the rest of your life. Unlike conventional diets there is no finish line: surgery requires an almost religious-like lifestyle change. Patients must follow a high protein, low carbohydrate diet every day for the rest of their life in order to lose weight and maintain that weight loss. Patients will need to avoid simple carbohydrates including sugary snack foods and fried food. Snacking, when allowed, must be mindful including lean protein and low-glycemic fruits and vegetables. Liquid restrictions mean no beverages before or after meals and no drinking with meals: this helps the surgical pouch work correctly. Patients learn and accept that some things will make them sick, smells will affect them differently, and sometimes they will feel emotionally blue because of the irreversible restrictions of surgery. We have this life-changing surgery with all its restrictions and then return to the very environment in which we became obese: of course we suffer feelings of sadness at times.

Support: As with other life-changing disease, patients seeking treatment and recovery from morbid obesity with surgery benefit from support. While no one can understand another persons exact journey we can certainly share the collective experience of obesity, life long dieting and weight gain, and finally the somber decision to undergo treatment with surgery. While patients are likely to cluster to support groups both live and online before surgery and in the first year following surgery, there is a tendency to drift away from support groups as time passes. Evidence suggests, however, that solid support relationships are a key in sustaining personal efforts for health, weight control and wellness with bariatric surgery.
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Activity: The inclusion of physical activity as part of lifestyle change with surgery will make a difference in the long term successful weight management of bariatric patients. Early post-operative patients are directed to get 150 minutes of exercise a week, that is about 20 minutes a day. Patients who do this and more will successfully manage their weight loss and weight maintenance. Patients who regain weight often admit they never really got around to including physical activity in their new lifestyle. Studies indicate exercise need not be strenuous or exhausting. Physical activity simply must move us beyond the normal motion required of daily life.

Weight loss surgery patients tend to idolize their surgeons and bariatric teams crediting them with restoring their health. But long after the surgical wounds have healed and the routine checkups are simply annual office visits it is up to the patient to own their surgical tool and manage it in a way that keeps their disease in remission.


Read Kaye's Day 6: Beyond 5 Day Pouch Test

Kaye Bailey copyright 2010 - All Rights Reserved

Article Source: Three Keys to Lasting Weight Loss Surgery Success

Sex After Weight Loss Surgery - When is it Okay?

By Kaye Bailey

People recovering from bariatric surgery for the treatment of morbid obesity often look forward to a healthy sex life that may have alluded them due poor health associated with obesity or simply the mechanics of sexual activity with a morbidly obese body. Surgeons are frequently asked how soon a patient will be able to enjoy sexual intimacy following bariatric surgery.

Bariatric surgery, although less invasive than it was 20 years ago, is still considered major abdominal surgery. Most of the commonly performed procedures including gastric bypass, adjustable gastric-banding (lap-band), and gastric sleeve, are done using the advanced laparoscopic method of surgery. Laparoscopic gastric surgeries reduce risk to patients and decrease hospital stays over the traditional open methods of surgery. This improves the rate of recovery from surgery. The minimally invasive laparoscopic procedures are performed by surgeons inserting cameras and instruments through small incision ports in the abdomen. While there is no large wound that requires healing, there is unseen internal bruising that will require time to heal.

Most doctors will advise their patients to avoid sexual activity for the first few weeks following surgery. The physical stress of surgery may rupture sutures or tear incisions and prolong healing. Patients should ask their surgeon when it will be appropriate to engage in sexual activity following surgery. It makes sense to think of sex as form of exercise: If your doctor clears you for physical activity, you are also likely safe for sexual activity.

Women who have recently undergone bariatric surgery are advised to practice a reliable form of birth control, even if they have been unable to conceive in the recent past. Pregnancy during the rapid phase of weight loss is not desired as both the mother and the fetus may suffer nutritional deficiencies. Most bariatric centers advise female patients to wait until weight loss has stabilized before attempting to become pregnant.

Patients are likely to proceed cautiously as they engage in sexual intimacy following major surgery. While focus should be on enjoying the moment with your partner it is wise to be aware of your body and listen to any warning signs it may be sending. Symptoms such as pain, shortness of breath, fatigue, or dizziness are warnings to slow down what you are doing, whether you are a man or woman. The pain may be attributed to angina, which is temporary pain or pressure in the chest when the heart does not get enough oxygen. If that is the case changing positions or taking a moment for rest may be beneficial. Prolonged or acute pain should not be ignored and medical attention should be sought immediately.

Sex is obviously part of an overall healthy life and something most people look forward to as they recover from significant illness, including morbid obesity. As weight is lost it is likely sexual activity and the desire for sexual activity will increase. On a basal level, an active sex life is a statement of good health: it says positive things about your overall level of fitness and your recovery from morbid obesity. It also may be sign of healthy relationships, another good measure of overall health.

Patients should always seek the advice of their doctors regarding sexual health. Sexual issues are important to discuss even if such a discussion tests our comfort level when we bring our concerns to our physician. Keep in mind your doctor is in the business of taking care of your health and that includes your sexual wellness; you cannot surprise your physician by voicing your most personal concerns about your sexual health.

We often say that weight loss surgery is our second chance at living and most would agree that a healthy sex life brings a satisfying component to our ongoing pursuit of health and wellness. Having realistic expectations for recovery is the first step in creating a healthy sex life following weight loss surgery.

Kaye Bailey (c) 2010 - All Rights Reserved

Article Source: Sex After Weight Loss Surgery - When is it Okay?

Can You Fly With Those Wings?

Bat Wings After Massive Weight LossBy Kaye Bailey

That hanging flapping upper arm of the song leader in the second grade was a great source of jokes for many of us as children. But after massive weight loss when we look in the mirror only to see our own arm flap waving back at us it is no laughing matter. A surgical procedure called brachioplasty may be the solution to correct what surgeons politely call "skin redundancy and laxity" following massive weight loss.

Recently, as thousands of people are losing significant amounts of weight with bariatric weight loss surgery, we are hearing more about bat wings and the reconstructive surgery many are turning to for skin removal and arm contouring. Bat wings might be fine if they could help us fly, but excess upper arm skin is a nuisance and embarrassment. While in most cases, post-bariatric patients undergo brachioplasty for cosmetic reasons, there are functional complaints resulting from the deflated flap of skin left behind by weight loss. Patients report rashes, skin breakdown, pain from skin pinching, and difficulty in finding clothing to fit the smaller torso while accommodating excessive arm girth. Patients also report embarrassment over the waving arm flap saying they preferred the more common embarrassment of morbid obesity to the stare-getting physical deformity of flapping bat wings.

Ideally a bariatric patient will have achieved weight loss and be maintaining a healthy weight in the Body Mass Index (BMI) "normal" range of 18.5 to 24.9 before seeking surgical treatment for bat wings. The skin should be deflated with very little subcutaneous fat remaining. The medical comorbidities common before bariatric surgery should be in remission such as diabetes, sleep apnea, cardiac disease and asthma and nutritional status should be favorable. In addition, before brachioplasty surgery is scheduled the patient must clearly understand the outcomes of the surgery.

Brachioplasty effectively removes excess skin following massive weight loss, however it unavoidably leaves a perceptible scar on the underside of the arm from armpit to elbow. Patients must understand they are trading unsightly excess skin for what some may consider an unsightly surgical scar. According to Dr. Michele A. Shermak, FACS, of Johns Hopkins School of Medicine in Maryland, "There are no effective scarless or minimally invasive techniques that can adequately reduce the skin laxity and excess associated with massive weight loss. Neither liposuction nor laser or light-based tightening therapies typically apply to the post-bariatric upper extremity."

The most commonly performed procedure is traditional brachoplasty in which a "T" incision spans from the armpit to the elbow. Skin is removed and the remaining skin is smoothed and closed with surgical sutures. A drain is placed in each arm and is typically removed after one week. Postoperatively the patient should be followed for wound and scar management. Brachioplasty may be performed as an outpatient, stand-alone procedure. However, it is often included with other procedures for excess skin management following massive weight loss, such as a lower body lift.

As with all surgical procedures there are risks. With brachioplasty the arm is prone to having more issues with wound healing due to the extreme need for mobility, leading to stress and shear forces. Other complications associated with brachioplasty may include discomfort, bleeding, postoperative relaxation of the skin leading to re-currrent laxity. Due to the risks of brachioplasty surgery and the overall complexity of the arm, it is critical to have the surgery performed by a board-certified plastic surgeon who is familiar with the anatomy, surgical procedure, and postoperative management.

Kaye Bailey 2010 - All Rights Reserved

Article Source: Can You Fly With Those Wings? Bat Wings After Massive Weight Loss

Kaye Bailey Article Syndication

Kaye Bailey EzineArticles

Recently syndicated articles by internationally recognized weight loss surgery expert Kaye Bailey:

Four Truths About Weight Regain After Weight Loss Surgery
Nobody undergoes weight loss surgery thinking weight regain will happen to them. But statistics indicate that 80 percent of those who undergo gastric bypass, gastric banding, or gastric sleeve weight loss surgery will at some point regain some of the weight they lost initially with the surgery. Learn four truths about weight gain after weight loss surgery.
Read Full Article

Emergency Preparedness For Weight Loss Surgery Patients
Weight loss surgery patients should take some extra steps in preparing an emergency readiness kit for use in the event of a natural or national disaster. Here are some good suggestions for preparing a special needs kit for the bariatric patient.
Read Full Article

Gastric Bypass Dumping Syndrome - Three Foods That Cause It
As pre-op weight loss surgery patients we are taught to fear the mysterious dumping syndrome and in most cases we are told that avoiding sugar will prevent the occurrence of dumping syndrome. So it comes as a surprise when after having a malabsorptive gastric surgery we experience symptoms that we think are dumping syndrome, yet sugar has not crossed our lips. In this article we take a look at dumping syndrome so that we can understand the full picture - beyond the sugar - and avoid the foods that may cause it.
Read Full Article

Budget Tips For Eating Healthy After Weight Loss Surgery
After gastric bypass, gastric banding or gastric sleeve weight loss surgery we know we must follow a healthy high protein diet in order to lose weight and maintain weight loss. In these economic times it is natural to be concerned about the cost of a specialized diet. Follow these helpful tips to sustain your weight loss surgery diet without breaking the bank.
Read Full Article

Kaye Bailey EzineArticle Profile

Budget Tips For Eating Healthy After Weight Loss Surgery

By Kaye Bailey

After gastric bypass, gastric banding or gastric sleeve weight loss surgery we know we must follow a healthy high protein diet in order to lose weight and maintain weight loss. In these difficult economic times it is natural to be concerned about the cost of a specialized diet. Follow these helpful tips to sustain your weight loss surgery diet without breaking the bank. By making a special effort when planning, shopping and preparing meals it is painless to save money and follow a nutritional program to benefit our health today and in the future.

• Make a weekly menu of dinner meals. Focus on protein dishes that can be repurposed as lunches. Side dishes should be fresh seasonal vegetables and fruits or frozen vegetables requiring minimal preparation.

• Plan two or three "routine" breakfast selections. Most WLS patients have a lower tolerance for food upon waking and eventually find a few things that consistently settle well on their stomach pouch first thing in the morning. Have these routine selections on hand at all times to avoid starting the day off with a grumpy pouch.
• Follow the weekly grocery sale adds and take advantage of specials and coupons. Use grocery store loyalty cards for added savings. Avoid sales for processed simple carbohydrates (junk food) because these foods are referred to as "slider foods" and they often cause weight gain in WLS patients. Remember, a slider food on sale is still a slider food.
• Purchase items that can be used in multiple recipes and for different meals such as canned beans, eggs and flash frozen poultry and fish pieces. Stock up on sale items and repackage bulk purchases for single meals or single serving sizes and freeze to avoid waste.

Weight Loss Surgery Recipes

• When shopping, follow the "Protein First" rule and make protein selections first. Look for fresh lean meat, pork and lamb in the meat department. Add poultry and fish from the meat department or frozen meat section. Shop for low-fat dairy protein and select low-fat cottage cheese and yogurt as well as eggs. Add vegetable based protein to your diet with canned beans, dried beans and legumes, and tofu products.
• Take advantage of locally grown produce available seasonally at roadside stands and farmers markets. For an exercise bonus gather your produce at "pick-your-own" farms and orchards to save money and burn calories.
• Eliminate pricey beverages from your diet in favor of filtered tap water. It is less expensive and better for the environment. Flavor water with a squeeze of fresh lemon or fresh ginger. Add frozen berries for a refreshing treat. Make sun tea with tea bags instead of buying manufactured tea beverages. You will get a purer beverage and save money too.
• Prepare your meals at home rather than eating out. You can control the ingredients and avoid things that interfere with your healthy dietary goals following weight loss surgery.

Build on your experience each week to become a health savvy and budget wise shopper so that you can enjoy your healthy life following surgical weight loss.

Kaye Bailey - 2010 - All Rights Reserved

LivingAfterWLS
5 Day Pouch Test

Article Source: Budget Tips For Eating Healthy After Weight Loss Surgery

Emergency Preparedness For Weight Loss Surgery Patients

By Kaye Bailey

Following weight loss surgery patients make a multitude of adjustments in their lives to accommodate the dietary and nutritional needs of an altered gastric digestive system. Even if weight loss has long been accomplished patients who have undergone gastric bypass, gastric banding or gastric sleeve surgical procedures must, for the rest of their life, maintain rigorous nutritional and dietary habits in order to be healthy. After time these adjustments feel like second nature to the patient and even those around them. But in preparing an emergency kit for use in the wake of a natural or national disaster it is essential that weight loss surgery patients treat themselves as "special needs" and ensure their nutritional and dietary needs are provided for in the event the emergency kit is put into service.

Flood, fire, national disaster, or the loss of power from high winds, snow, or ice frequently jeopardize the health and safety of thousands of Americans each year. This year weather events and natural disasters have been particularly harsh throughout the world and many thousands have found themselves without food, shelter or warmth. While we cannot prevent natural or national disasters we can assemble emergency supply kits to improve our survivability when disaster strikes.

A well-prepared basic emergency supply kit will contain items to provide for the basics of survival: fresh water, food, clean air and warmth. The Federal Emergency Management Agency (FEMA) recommends the following items be included in a basic emergency supply kit:

• Water, one gallon of water per person per day for a least three days, for drinking and sanitation
• Food, at least a three-day supply of non-perishable food
• Battery-powered or hand crank radio and NOAA Weather Radio with tone alert and extra batteries for both
• Flashlight and extra batteries
• First aid kit
• Whistle to signal for help
• Dust mask, to help filter contaminated air and plastic sheeting and duct tape to shelter-in-place
• Moist towelettes, garbage bags and plastic ties for personal sanitation
• Personal hygiene items
• Wrench or pliers to turn off utilities
  
• Can opener for food (if kit contains canned food)
• Local maps
• Cell phone with chargers

Emergency readiness kits should provide water, food, clean air and warmth for 72 hours. Keeping that in mind a "special needs" weight loss surgery patient should consider including the following items in their personal readiness kit:

• Vitamins and supplements for three days. Additional dosages of vitamins B and C may be included to relieve stress and boost immunity.
• Non-NSAID over-the-counter pain relief medicine. Most surgical weight loss patients are discouraged from using NSAID medication for pain relief. Make sure acceptable OTC pain relief is included in the First aid kit.
• Vitamin fortified or protein fortified powder drink mixes in individual packages. These are useful in adding minerals and nutrients to the diet while stretching the water supply because when mixed with the water rations they provide hydration and vitamin and mineral nutrition.
• Ready-to-Drink (RTD) and Ready-to-Eat (RTE) protein drinks and protein bars. A weight loss surgery patient must have a minimum of 60 grams protein per day for best health. Provide at least 60 grams of dietary protein per day for three days of emergency use.
• Sugar free hard candy to supplement food intake and keep the mouth moist.
• Additional bedding or clothing for warmth. Body temperature regulation is difficult for those having lost body weight or body mass. Provide extra items for warmth in the event of a disaster that subjects the weight loss surgery patient to extreme cold or elements.
• Emergency response information for the treatment of a bariatric patient including contact numbers. Make this information readily available to first responders.

Gather items for the emergency preparedness kit in one location. Stow the items in a portable duffel bag or plastic bin that is accessible and labeled for easy access in the event of an emergency. Ideally each household member will have a kit tailored for their needs. Periodically check the kit and replenish items that have expired. Make certain all contact information is current. It is not easy to think about facing a disaster, but should the day come when the emergency kit is needed a little preparation will go a long way in making a bad situation better.

Kaye Bailey (c) 2010 - All Rights Reserved

Kaye Bailey is an internationally recognized writer, speaker and weight loss surgery advocate. She is the author of the highly successful weight loss surgery back to basics plan: 5 Day Pouch Test and the 5 Day Pouch Test Owner's Manual. Her follow-up book, Day 6: Beyond the 5 Day Pouch Test, was published in December 2009. It provides guidance for long-term weight and health management with all bariatric surgical procedures. Ms. Bailey is known for her powerful "you can do this" manner and her belief in the power of personal responsibility. She is the founder of LivingAfterWLS, LLC parent company to the LivingAfterWLS.com and 5daypouchtest.com websites. Supporting both websites is the LivingAfterWLS Neighborhood, an online compassion-driven community for weight loss surgery, gastric bypass and gastric banding patients.

LivingAfterWLS
5 Day Pouch Test

Article Source: Emergency Preparedness For Weight Loss Surgery Patients

Avoid Fried Foods - Prevent Gastric Bypass Dumping Syndrome

By Kaye Bailey

Anyone who is awake knows that fried food is not a healthy dietary choice. A high fat diet is believed to be a contributing cause of diabetes, heart disease, overweight and obesity. But Americans continue to load their plates with fried food because we have developed a taste for it and because food producers make products that taste good and are affordable.

Overweight people who have undergone bariatric weight loss surgery to control their weight are encouraged to follow a diet high in protein and low in fat and carbohydrate. This has been shown to effectively work with the weight loss surgery to reduce weight and control weight over long periods of time. Living in a world where high fat food is ever present, the surgical weight loss patient is often tempted to indulge in fried food often thinking that small amounts of fried food will not negatively affect their diet or health. However, eating fried food, even in small amounts, can have catastrophic consequences for gastric surgery patients.

In general fried food is bad for us simply by the nature of its nutritional composition. Consider this: A 6-piece serving of fried chicken tenders contains 401 Calories; 16 grams Protein; 8 grams Fat; 57 grams Carbohydrate. The FDA calculates this at 3 1/2 starch/bread servings and 1 lean meat serving. Its easy to figure out how we have become "obese nation" when you consider many children are weaned from the bottle right to the fast food fried chicken pieces.

This nutritional data indicates the fried chicken tenders are a high fat carbohydrate. When a person who has undergone a malabsorptive gastric surgery such as gastric bypass eats high fat carbohydrates they are at imminent risk of dumping syndrome. Gastric Dumping Syndrome, or rapid gastric emptying, is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. The syndrome is most often associated with malabsorptive gastric surgery, specifically gastric bypass surgery. Symptoms of dumping syndrome may manifest immediately after eating or within three hours of eating. Symptoms may include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. Symptoms do subside as insulin levels return to normal. Many patients experiencing dumping find comfort in lying down or sipping on fortified water or energy drinks served at room temperature.

Not only is dumping syndrome physically uncomfortable it can be unpredictable and embarrassing. Many patients experience profuse sweating which can be embarrassing and difficult to explain to those unaware of the condition. At other times a patient may suffer from confusion and become disoriented which may appear to be intoxication or diabetic distress to someone unacquainted with the signs and symptoms of dumping syndrome.

So the consequences of eating fried food after a gastric weight reduction surgery are twofold: immediate risk of dumping syndrome and long term risk of weight gain and the diseases associated with a high-fat diet.

Gastric surgery patients, specifically gastric bypass patients, may successfully avoid dumping syndrome by eating a diet of carefully chosen lean protein combined with low glycemic fresh fruits and vegetables. Patients are instructed to avoid simple sugars, simple carbohydrates and high-fat carbohydrates and to avoid drinking liquids with meals. At the onset weight loss surgery patients are instructed to eat a high protein diet following surgery.

Kaye Bailey - 2010 - All Rights Reserved

Kaye Bailey is an internationally recognized writer, speaker and weight loss surgery advocate. She is the author of the highly successful weight loss surgery back to basics plan: 5 Day Pouch Test and the 5 Day Pouch Test Owner's Manual. Her follow-up book, Day 6: Beyond the 5 Day Pouch Test, was published in December 2009. It provides guidance for long-term weight and health management with all bariatric surgical procedures. Ms. Bailey is known for her powerful "you can do this" manner and her belief in the power of personal responsibility. She is the founder of LivingAfterWLS, LLC parent company to the LivingAfterWLS.com and 5daypouchtest.com websites. Supporting both websites is the LivingAfterWLS Neighborhood, an online compassion-driven community for weight loss surgery, gastric bypass and gastric banding patients.

LivingAfterWLS
5 Day Pouch Test

Article Source: http://EzineArticles.com/?expert=Kaye_Bailey

http://EzineArticles.com/?Avoid-Fried-Foods---Prevent-Gastric-Bypass-Dumping-Syndrome&id=4237594

2009 All Star Award - Email Newsletters

We have just learned that LivingAfterWLS has been awarded the Constant Contact 2009 All Star Award for Excellence in Email Marketing! That means the emails we provided to our LivingAfterWLS community free of charge meet the highest standards of excellence in the email marketing industry! I am so pleased with this and thrilled that we can continue to share with you, our loyal readers, quality material of interest, meeting the high standards you have come to expect. It is a beautiful day in the LivingAfterWLS Neighborhood!

LivingAfterWLS publishes three inspiring email newsletters that promote personal responsibility and positive self-empowerment as a means to succeed long-term with surgical weight loss. They are free to email subscribers whom we treat with respect and privacy never selling our list.

You Have Arrived is our flagship newsletter published twice monthly. You will find inspiring and motivational articles in addition to topics on nutrition, fitness, healthy cooking and bariatric news.

Recipe of the Week is our once weekly cooking and nutrition newsletter. Each week you will find great family friendly recipes using fresh healthy ingredients that will please your palate and enhance your well being while being mindful of the specific need of surgical weight loss patients.

Free 2009 Best of Cooking with Kaye Download
21-Page Download; 28 of your favorite Kaye recipes from 2009

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5 Day Pouch Test Bulletin is our monthly motivational newsletter that supports our back to basics program, the 5 Day Pouch Test. This program is for those who feel they are not fully using their weight loss surgery tool and is useful for those who have stalled weight loss, or perhaps regained some weight.

Sign up for Award Winning LivingAfterWLS Newsletters

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Weight Loss Surgery is Easy? NOT!

From my syndicated article file, published in 2005. Not much has changed since then. Please share your experiences with public perception of surgical weight loss. Thanks for stopping by.

Gastric Bypass: The Easy Way Out of Fat Land - Right?
By Kaye Bailey

If you listen, even for a moment, to the talk in overweight communities you will almost always hear that gastric bypass weight loss surgery is the “easy way out” of Fat Land. People with weak spirits and good insurance get a lucky break, have their stomachs whacked and stapled and lose weight the easy way. Weight Loss Surgery: seen by pious public to be surgical baptism for the guilty gluttonous slothful.

But those of us who step in the water to be cleansed of our fatty sins know better. Weight loss surgery is NOT the easy way out, a simple dunking of the repentant, the sins atoned, and the price paid, the soul and body healed. We know the atonement is paid every day for the rest of our lives when we set our healthy house in order with gastric bypass.

We understand that WLS is not easy. Why, then, does the public think it’s redemption to weight loss?

First: what the public sees is a rapidly diminishing person recently repaired by gastric bypass. The pounds melt away seemingly in a plain sight. What hides behind the curtain are the ugly demons. Dumping? We don’t talk about it. Vomiting? We don’t tell our regurgitating stories. Head games driving you insane? Who you going to tell? Who is listening? Exercising? Nobody wants to hear about the “E” word. So what the public sees front and center stage is a person consistently succeeding at massive weight loss; a person glowing in their own rebirth and betraying the fat and hopeless around them. How else can it be explained? WLS must be the magic pill, the easy-way-out of obesity hell.

Second: the WLS grass-roots public relations machine tells the public gastric bypass is easy, thus we become our own worst enemy. Tell me if this doesn’t sound familiar: “I can still eat the same things, just less of them! ha ha ha!” or how about, “I lost 145 pounds and never had to do a moments exercise – WLS is fabulous that way – no exercise required.” And so the popular belief perpetuates that fat glutton slobs can lose weight just by eating less of the same foods and never exercising. Brilliant! How easy is that?

Let me tell you what weight loss surgery is really like for me.

I am six years post-op. Two nights ago I vomited my dinner (bacon-seared sea scallops and green beans) because it was just a bit too greasy for my sensitive stomach. A week before that I became deathly ill, it’s called dumping, from snacking mindlessly on Chinese chow mein noodles. Disorientation, hot sweats and then cold chills – dumping – a dire consequence of eating the wrong foods with the malabsorptive system. This morning, just like most mornings, I walked two brisk miles on the treadmill to begin my day. This evening I spent 25 minutes strength training to maintain my muscle tone, keep my metabolism running high and making damn sure I don’t regain one single pound.

And this is how it will be for the rest of my life. I will vomit, dump, exercise and be vigilant day in and day out if I want this easy weight loss surgery to work for me.

My body does not take weekends off from weight loss surgery. I don’t get chocolate cake just because it’s my birthday. I do not have a double-cheeseburger with fries and a shake just because I’ve had a stressful day and I deserve it. My body is on the gastric-bypass plan 24-7.

Do you think that’s easy?

Weight Loss Surgery post-ops understand what I’m talking about. Many of us go through a phase of fighting the gastric bypass and engage in snacking or grazing. We out-eat the stomach pouch and regain weight and we become self-loathing. We vomit and dump and do it all over again thinking we can somehow trick the body. Eventually we learn and we get it: WLS is for life.

Weight loss surgery pre-op patients want badly to understand this, but the dieting culture has taught us to be strict for X-number days and then we get a free day. The culture has taught us if we can stick to a plan for X-weeks and lose X-pounds then we can “get back to normal”. We are all expert dieters by the time we elect to have gastric bypass surgery.

There is no back to normal after WLS – it is a lifetime lifestyle commitment.

Kaye Bailey © 2005 - All Rights Reserved


Article Source: http://EzineArticles.com/?expert=Kaye_Bailey http://EzineArticles.com/?Gastric-Bypass:-The-Easy-Way-Out-of-Fat-Land---Right?&id=71012

Rumbly-Grumbly Tummy

Recently I was asked about the "inactive stomach" that is separated from the pouch in a gastric bypass surgery. Here is one of my syndicated articles that addresses the issue of the rumbly-grumbly tummy:

If you’ve been enjoying life after gastric bypass surgery you will know exactly what I’m talking about. That rumbly-tumbly stomach growl that’s more bark than bite. It’s the inactive tummy talking, the lower part of the stomach that was bypassed. And it growls at the oddest moments seldom accompanied by hunger pains. My inactive tummy is particularly talkative at bedtime, I think it remembers the refrigerator front bedtime binges from my previously life.

Remember the surgical diagrams you studied before surgery: a tiny stomach portion we call the pouch was separated from a larger portion, which is the inactive or bypassed stomach. In the gastric bypass procedure the stomach is left in place with blood supply – it is still and active organ yet no longer a reservoir for food. In some cases it may shrink slightly and the muscles may atrophy, but for the most part it remains unchanged. In fact, the “inactive” tummy is quite active. The inactive tummy is an around-the-clock chemical factory keeping your body in balance.

And for all it’s hard work what do we do? We don’t feed it. No wonder it’s talking!

The lower stomach still contributes to the function of the intestines even though it does not receive or process food - it makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known. So when you hear that rumbly-tumbly stomach growl you can smile happily knowing your body is hard at work keeping you chemically healthy and well.

Vitamin D: Miracle Vitamin?

As recipients of surgical weight loss we need to be vigilant about our nutritional intake and nutrient balance in our bodies. Lately the headliner vitamin in mainstream media is Vitamin D. The jury is still out on the impact of vitamin D deficiency in surgical weight loss patients so we are left to make sense out of data presented for people without WLS. I found this article in Clean Eating which succinctly brings to focus our need for vitamin D. Take a look:

As Reported in Clean Eating (March/April 2009: Page 86)

Is vitamin D really the "miracle vitamin" I keep hearing about?
by Jonny Bowden, PhD, CNS

"It's pretty darned close. Research has shown a link between vitamin D and lower levels of both breast and colon cancer, higher measures of physical strength and performance in older adults, mood enhancement and stronger bones. In the famous Framingham Heart Study, those with low levels of vitamin D doubled their risk for heart disease. And in the follow-up study, men who were vitamin D deficient were twice as likely to have heart attacks. If that weren't enough, a recent study in the Archives of Internal Medicine showed that the individuals taking vitamin D were seven percent less likely to die of life threatening conditions including cancer, cardiovascular disease and diabetes. You might think we get plenty of vitaminD, but we don't. Even the American Academy of Pediatrics is suggesting that we double the recommended daily allowance for children and infants. The current recommended daily allowance (RDA) is between 200 to 600 IUs. Vitamin D is inexpensive and comes in a tiny little soft gel that's very easy to swallow. I believe we'd all benefit from supplementing with 1,000 IUs a day. Foods that contain high levels of vitamin D are cheese, egg yolks, milk, certain fish and cod liver oil."

Participant Request: Your Personal WLS Experience

Hello Neighbors!

I am appealing to you for help with a book being developed by Tricia Greaves, owner/president of "Be Totally Free". She is the founder of a program to address issues of weight control, weight loss and eating disorders. Her work is very good and very much aligned with our LivingAfterWLS Empowerment Philosophy. As part of her growing body of work and support network she is researching weight loss surgery.

You are invited to participate in the survey and contribute to this exciting project. I have done the survey and I trust that Ms. Greaves will treat our topic with utmost sensitivity, accuracy, and kindness.

Click here: Weight Loss Surgery: Your Personal Experience

Neither myself or LivingAfterWLS is affiliated with Be Totally Free, or Ms. Greaves and we will not receive compensation for your participation. However, I do ask that you mention the LAWLS Neighborhood as part of your response to Question 8 about your support network. I do not think we can ever over-emphasize the value of support in this life long journey.

Thanks for taking a moment from your busy day to help build on the growing body of information about our very unique way of life.

CHEERS!
Kaye