Hiển thị các bài đăng có nhãn lapband. Hiển thị tất cả bài đăng
Hiển thị các bài đăng có nhãn lapband. Hiển thị tất cả bài đăng

Thứ Ba, 7 tháng 5, 2013

Dr. Manny: Governor Christie is adding years to his life by having lap-band surgery

  • ChrisChristie.jpg

    New Jersey Gov. Chris Christie answers a question in this April 30, 2013 photo taken in Long Beach Township, N.J., during a town hall meeting.AP

I am very pleased that Gov. Chris Christie came out publicly to talk about his weight-reduction surgery. I know that for years he has struggled with his weight, but one thing is for sure now: He will add years to his life.

By doing this at the age of 50, he could potentially reverse all the negative side effects of obesity, such as type 2 diabetes, hypertension, early joint-degeneration and cardiovascular disease.

I am also very happy that he is the governor of the state of New Jersey, because he continues to show us that pragmatism and common sense always works.

I spoke with Dr. Hans Schmidt, the director of the bariatric surgery center at Hackensack Medical Center in Hackensack, New Jersey, to find out more about the lap-band procedure.

What is lap band surgery?
“It’s a laparoscopic procedure, meaning it is done through small incisions. The gist of it is that you’re putting an adjustable band – a circular ring – around the upper stomach. It is then connected through tubing that goes to a port under the skin, which doctors can use to adjust the band.”

Who qualifies for this surgery?
“There is pretty defined criteria. You have to have a BMI (body mass index) of over 40, which is about 100 pounds over your ideal weight.  Or, you could (qualify with a) BMI of over 35 if you have weight-related medical conditions like diabetes, high blood pressure, sleep apnea or severe arthritis.”

How do you prepare for the surgery?
“Once you meet the medical criteria for surgery, each program has their own procedure. Most of the time, you have to be evaluated by a nutritionist beforehand and undergo medical clearance with your doctor to make sure you’re safe for surgery. Sometimes, you even go through a psychiatric evaluation to make sure you don’t have depression, an eating disorder or any other underlying reasons for overeating. Once the surgery is approved, some places encourage a modified diet a week or two before surgery – a liquid diet or a lighter diet to lose a few pounds beforehand.”

What is the recovery process like?
“The recovery process for the band is very quick. Many go home the same day, (but) some stay in the hospital overnight. Most people can go back to their normal activity within one to three days after surgery. That includes most normal activities – not going to the gym or doing heavy exercise –  but most day-to-day activities.”

What are the risks associated with lap-band surgery?
“There are risks associated with any surgery, of course.  It is under general anesthesia, so you have to be asleep, and there are always cardiopulmonary risks with that. But of the bariatric surgeries, it is probably the safest in the short-term. There are few immediate risks, other than injury to surrounding organs – but that’s very rare.”

How much can patients expect to slim down?
“We shoot for a loss of between a half and two-thirds of their excess body weight. With the band, the weight loss is typically pretty slow and steady. There’s a rapid weight loss after the first few months – maybe 10 pounds a month. And then with the band, it’s usually 1 to 2 pound per week, so 4 to 8 pounds per month over many months. Some other operations have really rapid weight loss, whereas weight loss with the band is slow and steady over time. If you lose weight slowly enough, the (excess) skin may be less of an issue.”

How do your lifestyle and eating habits change afterwards?
“That’s where the challenges come. You have to get the band adjusted every four to six weeks for the first year, (and) less as time goes on. The point of the band is to eat less food. It may take away your hunger to a degree, but the bottom line is you will get full faster and eat much less food throughout the day. If you’re a good patient, you should incorporate exercise too.”

What are the repercussions if you don’t follow a new diet?
“If you eat too much, or too fast, food tends to get stuck. It is trying to go down the esophagus into the stomach, which has the band around it. The food can get stuck in your throat and some people end up regurgitating or throwing up.  But the bottom line is if you don’t follow the rules, you won’t lose weight. It does require effort on behalf of the patient to lose the weight. If you do, the results are pretty good.”

Is this for everyone?
“You have to meet the BMI criteria; it’s not just overweight people but those who are morbidly obese. There are several different types of weight loss operations available.  The band is good for people who are compliant, able to follow up and come every four to six weeks, and are devoted to losing the weight and doing the follow-up. People who aren’t may be better served with other procedures.”


View the original article here

What to eat after lap-band surgery

  • Portion Size

I know everybody is very excited about Gov. Chris Christie’s new effort to lose weight. Christie has reportedly lost 40 pounds so far, but it is important to remember that maintaining that weight loss will have a lot to do with adopting the proper diet and lifestyle. We talked to Rebecca Soloman, clinical nutrition coordinator at Mount Sinai Hospital in New York City, for the best diet tips to follow after lap-band surgery.

Eat small portions
In the weeks and months after surgery, it is essential for patients to focus on limiting their portion sizes. Lap-band surgery decreases the size of the stomach, making it very difficult, and even painful, to ingest large quantities of food.

“Most patients are full after a quarter to a maximum of half a cup of food at one sitting,” Soloman said.

Consuming more than that will cause discomfort and could lead to vomiting, Soloman noted. She recommends that patients eat slowly and chew food thoroughly to avoid discomfort.

Focus on high protein foods
“We found, especially in bariatric weight-loss patients, that protein is the food group from which they derive their greatest sense of fullness or satiety,” Soloman said. In the first three to four weeks after surgery, Soloman recommends focusing on soft proteins like Greek yogurt, pureed chicken, soups or cottage cheese. This will also help patients avoid becoming protein deficient.

After the first month, patients can begin experimenting with non-pureed foods, focusing on softer flaky fishes, the dark meat of chicken or lean ground beef. “We increase the texture but not necessarily the quantity,” Soloman noted. “We like to focus on the term ‘gentle satiety,’ you want to be mindful of not overeating.”

Avoid drinking and eating at the same time
One of the most important rules to follow after lap-band surgery: Avoid eating and drinking simultaneously. While staying hydrated is important, Soloman advises patients to stop drinking 10 minutes prior to eating, and then avoid drinking until 45 minutes after they’ve finished their meal.

In the first few weeks after surgery, the stomach is so tiny that consuming a liquid and solid at the same time could cause vomiting. Furthermore,  “just a few swigs of water could push food out of the stomach, causing a premature sense of emptiness,”  Soloman said.

Limit pasta, rice, bread
While eating a little bit of fiber is fine, most patients do not tolerate rice, pasta or bread very well.

“They all expand when they absorb more fluids, like gastric juices,” Solman said. This can cause discomfort in patients, and they typically learn to avoid these types of foods, or eat them only in very limited qualities.

Consume soft fruits and vegetables
In the first weeks after surgery,  all fruits and vegetables need to be pureed.

“You could do a natural applesauce or make your own, pureed carrots, broccoli. You can use seasonings, herbs, spices to the extent that you tolerate them. Make it flavorable, so that it is enjoyable,” Soloman said.

Later, patients can introduce whole fruits and vegetables, avoiding fruit skins (like apple skins) or stringier vegetables.

Overall, it is important to remember that while lap-band surgery will help you lose weight, it will only work if you monitor your diet, too.

“It’s a tool, not a solution in and of itself,” Soloman said. “It’s effectiveness is related to what you put in your mouth.”


View the original article here