Several patients were in the office today who have done very well with their weight loss using the gastric band.Losing the last 15-20lbs is usually more about food choices, exercise and avoiding high calorie snacks than it is about finding a perfect band “adjustment.”Most patients learn this by having their bands adjusted too tight and needing a little bit taken out.When I see patients undergo a series of tiny fluid adjustments and complaining of stagnant weight loss, usually they are depending too much on the band and need to depend more on their food choices.Our support groups and Mindful Eating classes, taught by our nutritionist Prudence Ticknor, are a great way to refocus for those last few pounds.To sign up for the Mindful Eating series or to find out more about our support groups, give us a call at 702-313-8446.
We want to make sure that we are fueled to capacity to give us that extra edge we can get from being properly fueled and hydrated! Therefore, I’ve put together a few tips for the days leading up to the marathon as well as the morning of the race.
2 days prior to race: Friday 12/04
1.Load up on fluids. Stay away from alcohol as it dehydrates you and interferes with the proper storage of glycogen. Do a hydration check:Do you urinate frequently and is your urine pale yellow in color?If so, you are hydrating enough. If you do not urinate frequently and your urine is dark in color, you need to increase your fluids.
2.Avoid high fiber foods like beans, bran cereals, gassy vegetables or hard to digest foods like fried foods or meats.
3.At this point, don’t try anything new. Eat what you already know works for you.
Day before race: Saturday 12/05
1.This is not a day to overeat. It is not about the amount of food but the types of foods you choose.
2.Think mostly carbohydrates with only a little fat or protein. If you have a hard time with carbohydrates like rice, bread or pasta, then use a white flat bread, pita bread, grits or you can use your sports drinks or gels that you have been using during training.
3.Choose your carbohydrate meal for a late lunch, like around 3pm. Stick with a light dinner.
Race Day Nutrition & Hydration 12/06
1.Staying hydrated is most important. Drink 2–3 cups of water two hours before the race and 1–2 cups 15 minutes prior to the race.
2.Think about drinking fluids about every 20 minutes or at every race station. Whether you are carrying your own drink or not, let the stations be a reminder to drink. Do not pass up hydrating at a station.
3.The race starts at 6am. You may want to eat something light like a piece of toast and a half a banana or a small amount of oatmeal or grits with a little honey 3 hours prior to the race. Stop eating solids 3 hours prior to the race to give your body time to digest.Stick with liquids after the 3 hour mark prior to the race.
4.Stick to the sports drinks, gels or beans you have been using during training. Do not use anything new. Your sports drinks will provide you the carbohydrates and sodium that is needed. The American College of Sports Medicine recommends drinks that contain between 4 – 8% carbohydrates in the form of glucose, sucrose or maltodextrins. Great choices would be Gatorade, All Sport, or Powerade.
One topic brought up in the last support group was that some patients noticed that their restriction was tighter in the morning than later in the day and at night.For some the change is dramatic enough that they have trouble with solids in the morning and have to eat soft foods like yogurt, but seem to have too little restriction at night.Some patients don’t notice this difference at all, but for those that do, it can make finding the “perfect” adjustment more difficult.
We believe that the morning tightness is from increased blood flow to the stomach and intestines during sleep which increases the stomach wall thickness temporarily.Remember, any swelling can lead to increased restriction.So, if you are experiencing this, be sure to discuss it with our physician’s assistants, Brian or Melissa, during your adjustment visits.Also, patients considering the band procedure are welcome to attend support groups to meet other patients and learn more about living with the band.For more information on our support groups, please call 702-384-8446.
A recent study out of Baylor University confirms findings which we have already observed in our practice.The health benefits of losing weight also apply to older patients and that weight loss surgery can be safely performed in the older population, provided they are healthy enough to undergo general anesthesia.You are never too old to get healthier.Here is the link to that report: http://www.upi.com/Health_News/2009/06/26/Bariatric-surgery-not-riskier-for-seniors/UPI-29531245990735/
Also check out this YouTube video of our 72-year-old patient Don.
If you haven’t been to one of the gastric band support groups lately I can tell you that the patients that have been attending regularly have been extremely positive and helpful.The support they show each other and new group attendees is quite impressive.The “hot topic” last night was using Chia seeds for health and appetite control.Patient Becky even brought sample Chia seed gel shots.Prudence, our nutritionist/bariatric coach, likes the health benefits of Chia seeds as they are high in protein, fiber, and antioxidants.Also, the patients find that it can help curb hunger between meals and adjustments with very few calories.
At the latest support group, there was one person who had not yet had her surgery and she was able to get great input from experienced band patients firsthand.The next band support group meeting is August 25, 2009 starting at 6pm and ending at 7:30 pm.Meetings are free for all Gastric Band Institute and Surgical Weight Control Center patients and potential patients. Hope to see you there.
After surgery, most patients start off weighing their food with a food scale every meal and being very successful with their weight loss. When patients plateau or stop losing weight, it almost always corresponds to when they stop using the scale and “guesstimating” or eyeballing their meal portions.
In order for your brain to keep your body from being hungry, it will portion out enough food to keep your weight stable, or keep you from losing weight. The food scale makes sure that your portions are small enough that your body can lose weight. Also, that’s the most accurate way gastric band patients can know if they need a band adjustment. When the same size meal that used to fill them up, no longer does, an adjustment is needed. If you are eating different size meals you won’t know for sure when it’s time for an adjustment. Also, because the band is a mechanical device, it doesn’t change or adapt until we change it. It is very hard to adjust the band properly if the patient is eating inconsistent amounts. Sometimes the band may feel too tight and sometimes not tight enough if you are eyeballing the portion size and eating inconsistent amounts.
Almost everyone who stops losing weight after surgery will admit that they stopped using their food scale to weigh their 4oz meals. Please remember, the time to stop using the food scale is when you reach your goal weight.
Recently, the Gastric Band Institute performed the first several single incision gastric band procedures in Las Vegas.The procedure differs from the standard gastric band procedure in that instead of using 3-5 small incisions, a single larger incision is used to place the band.
Surgeons have been debating the merits of the single incision procedure for weight loss surgery and other surgeries like gallbladder surgery and appendectomy.However, the bottom line on single incision gastric band placement is that in selected lower BMI patients with smaller livers and thinner abdominal walls, it is a reasonable procedure with just a few more technical challenges than the standard 4-5 incision procedure.There does not appear to be any difference as far as pain or recovery between the two procedures, but which is cosmetically more appealing, 4-5 tiny incisions versus one larger more noticeable incision, is debatable.
We are pleased to be able to offer single incision gastric bands to some of our patients.Currently, technical equipment advances are being made that in the near future will increase the number of patients that can be offered this procedure.
Like I mentioned last Friday, we filmed a patient’s gastric band adjustment, or “fill” as we often call it, for those of you who want to see and understand how an adjustment is done.Below is a video of one of our patients, Ericka, with one of our physician assistants, Brian, undergoing a simple, five-minute fill.
We’ve also created a video of Brian demonstrating an adjustment on a model of a lap band and port for a more detailed explanation.If you have any more questions about gastric band adjustments, please post them here, or call the office at 702-384-8446.
