Alex Brecher

We carry all flavors of Built Bars at the BariatricPal Store. They're like a marshmallow texture center covered with a thin coating or rich chocolate.

It's a real thing. It's connected with specific surgeons and facilities. Google and you'll see the latest warnings.

The BariatricPal Store has the largest selection of variety and sample packs. Check them out at https://store.bariatricpal.com/collections/variety-packs

I had my lap-band in NYU in 2003. I've since revised to Bypass. Dr. Alfons Pomp is at Weil Cornell. He's originally from Canada I believe and a very well respected bariatric surgeon. If you're using him and his team, you're in great hands.

We carry a nice selection of Monkfruit sweeteners and monk fruit based products at https://store.bariatricpal.com/collections/lakanto

I just received the following email from Dr. Almanza's brother, who is legally representing Dr. Almanza and Grand View Hospital. According to them, the announcement from the CDC and WHO are "FAKE NEWS." We posted about these warnings from WHO and the CDC in the following topics: As a matter of transparency, I am going to post the emails and any communication I have with the hospital of their legal representatives. I will leave it up to our dear forum members to decide who they should believe. (I am not a Dr.) ... ------------------------------------------------------------------------- Dr. Brecher, good afternoon: In recent days there has been a series of fake news in relation to the Grand View Hospital of which I am their legal representative. Among the people concerned about our work, you stand up, that is the reason of making contact. It is imperative for us to make clear the following: THERE HAS NOT EXISTED NOR EXISTS ANY BACTERIA AT OUR HOSPITAL. As proof of this I annex official documentation that supports that we have NOT INCURRED IN ANY FAULT. It does not hurt to remind you that, under Mexican law, defamation among health professionals is punishable; this also includes international processes, for that matter I also include the official decree from the Government of Mexico. We hope that with the proof and information provided, NO FURTHER CONCERNS NOR COMMENTS FROM YOUR SIDE OR UNDER BEHALF THE INSTITUTION YOU LEAD WILL GO ON. Sincerely, Hugo Almanza Grand View Hospital Legal representative ------------------------------------------------------------------------- DOF - Diario Oficial de la Federación.pdf e1.pdf e2.pdf e3.pdf i1.pdf i2.pdf i3.pdf

The company marketing Dr. Almanza for many years sent out the attached warning. Are they also spreading FAKE NEWS?

We carry those as well at https://store.bariatricpal.com/collections/procare-health

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There are some really good surgeons and hospitals in Tijuana, Mexico. It's a real shame that a few bad apples are ruining it for all. According to the CDC, the surgeons, companies, and hospitals that are all linked to this superbug are: Grandview Hospital (owned by Dr. Mario Almanza) Dr. Mario Almanza Weight Loss Agents Obesity Goodbye Center

I just posted this a little while ago...

The following article was just posted in the San Diego Tribune. "With several patients in local hospitals struggling to recover, public health officials are warning San Diego doctors to be on the lookout for signs of a deadly infection linked to weight-loss surgeries performed in Tijuana The county Health and Human Services Agency this week alerted the medical community that four patients have popped up in local hospitals with drug-resistant superbug infections of the same type that prompted the U.S. Centers for Disease Control and Prevention to issue a travel advisory in early January. The CDC has continued to caution those who travel to Tijuana for surgery, as the number of cases have more than doubled. Most are connected to patients operated on at Grand View Hospital near the U.S.-Mexico border. To date, CDC officials said, a total of 25 cases of drug-resistant pseudomonas aeruginosa have been detected among U.S. citizens who crossed the border, usually for “gastric sleeve” surgery that significantly reduces the size of the stomach, accelerating the pace of weight loss. Pseudomonas is listed among the CDC’s top threats among microbes that can resist antibiotics. According to a 2013 report, the bug kills about 440 people per year in the United States and infects about 6,700. In January, CDC officials said that the subspecies detected among Tijuana weight-loss patients is particularly nasty due to its ability to destroy carbapenems, one of the most effective and broadly-acting classes of antibiotics available to modern medicine. Maroya Walters, a CDC epidemiologist with a doctorate in biochemistry and molecular biology, said Tuesday that while the world’s foremost public health agency saw its last Grand View case in late January, additional infections have continued to surface among patients who were operated on at other as-yet-unnamed Tijuana hospitals. The most recent case was detected on Feb. 12. The current rate of new cases, she said, has not reduced enough for the CDC to remove or change the travel advisory it issued in January. “Right now, we don’t have any assurance that the infection control issues have been addressed,” Walters said. In San Diego, Dr. Eric McDonald, medical director of the county public health department’s epidemiology and immunization services branch, said that his office became aware of two local cases, one in October and one in January, after his office issued a preliminary notice to doctors on Jan. 16. Neither of those cases, he said, is a San Diego County resident, with one residing elsewhere in California and another living out of state. He said two more patients, both who live in San Diego County but had surgeries in Tijuana not related to weight-loss at hospitals other than Grand View, were admitted to area hospitals with pseudomonas infections in late February. Three of the four cases, he added, remain hospitalized today and are being treated under special protocols designed to keep infectious diseases from spreading. “At this time, we have no evidence of secondary infections associated with these hospitalized cases,” McDonald said Monday. He said that having four cases pop up in San Diego hospitals made it important for his office to let all local doctors know that they need to be proactive, asking about surgery in Mexico and responding with extra precaution, including patient isolation, where appropriate. “We just wanted to reiterate that you shouldn’t wait until after you know that a person has this organism to begin taking contact precautions,” McDonald said. “If you know someone is coming in with an infection, and you know they’ve had surgery in Mexico, then you should take these precautions right away.” Eighteen of the 25 cases — 20 have been confirmed and five are suspected — occurred in patients who were operated on at Grand View Hospital, according to CDC epidemic intelligence officer Ian Kracalik. He said Mexican health officials told the agency they detected lapses in the procedures used to sterilize medical devices used in weight-loss surgeries. Kracalik said additional information on exactly which devices were improperly handled was not made available by the Mexican health agency that conducted the Grand View investigation. Initially, he added, Mexico’s La Comisión Federal para la Protección contra Riesgos Sanitarios or federal commission for the protection against sanitary risks, told the CDC that it had shut down the surgical areas of Grand View on Dec. 19. But there were strong indications that the surgical center near the U.S. border remained open, with several new infections appearing after patients underwent surgeries at Grand View after Dec. 19. “It is clear there was an ongoing risk during that period when the hospital’s surgical area was not supposed to be operational,” Kracalik said. Health authorities in Mexico said they were not available to discuss the developments Tuesday. Kracalik added that the CDC received word that Grand View shut down “sometime after Jan. 31,” which was the last date on which the CDC received a report of an infection case linked to the hospital. Most of the cases, the CDC representatives added, are associated with Dr. Mario Almanza, a surgeon whose website declares that he is the “leading bariatric weight-loss surgeon in the world.” Almanza received significant media attention in 2018 when he was named in a class-action lawsuit by former patients, including a lead plaintiff who said her procedure left her with complications including internal bleeding, according to coverage by Channel 10 News and others. Almanza, contacted through weightlossagents.com, the stateside travel agency whose phone number the doctor lists on his website, did not return a request for comment Tuesday. With Grand View apparently shut down, CDC officials said they noticed that Weight Loss Agents had begun referring weight-loss surgeries to another Tijuana hospital called the “Obesity Goodbye Center.” Reached through their promotional Facebook page Tuesday, the company said that while Almanza “performed procedures for a couple of days at our facility always following our sanitation protocols,” he is not affiliated with the hospital in any way. The center said its own sanitation practices “exceed international standards.” An attorney for Weight Loss Agents, Glenn Krinsky, said the company has done everything it can to cooperate with the CDC, including providing information on 700 patients it had referred to Grand View since August. The CDC’s Walters said the agency is following up with those patients to better gauge the spread of pseudomonas or other surgical infections."

BariatricPal Box of the Month Club Do you love getting surprises in the mail? Are you ready to get help losing weight, boosting your protein, and keeping your diet fun and exciting? Are you a fan of great flavors, easy meals, and snacks, and exclusive discounts? Join the Club! That is, the BariatricPal Box of the Month Club. Each month, members receive a unique bundle of store products and samples. No two months’ bundles are the same. Each month, the items in your bundle are carefully hand-picked by our store experts for you to enjoy. What’s in the box? It changes each month, so you will find out when you open it! You might get… Top-selling store products. Samples of our newest products so you can be first to try them! Great-tasting protein bars and shakes in both classic and daring flavors. Ready-to-eat snacks and/or instant meals – all high-protein, low-carb. Samples of vitamins, minerals, and health-boosting supplements. Other weight loss helpers, such as measuring aids. You can count on at least 8 to 10 items in each Box. You’ll get at least $50 worth of top-quality products and exclusive coupons every month. Getting the Box is the only way you could try all of these products without buying bigger quantities of them. Who is it for? YOU, if you want: Great-tasting, fun products. Exclusive discounts every month on the products you try. Variety, taste, and protein on your pre-op diet or solid foods post-op diet. Help losing weight with or without surgery. More protein, less sugar, and more flavor. Samples of new and delicious products without committing to an entire box. High-protein, nutritionist-developed menus to help you lose weight. When you fall in love with the contents of your monthly Box, you can buy them at The BariatricPal Store. We sell every product that we put in your Box, along with over 1,500 other bariatric and weight loss products. Plus, we guarantee the lowest prices anywhere and offer free shipping. Count on the joy of opening your box and discovering new products each month. Shipping is free! You do not need to worry about what the neighbors think because the Box is discreet – it has no bariatric-related words or logos. Join the Club and make weight loss fun!

Check out BariatricPal Multivitamin ONE "1 per Day!" Bariatric Multivitamin Capsules! With just ONE convenient & affordable BariatricPal Multivitamin ONE each day, you can get the bariatric vitamins and minerals you need to stay healthy! BariatricPal Multivitamin ONE was designed and developed by a team of the world's leading Bariatric medical professionals.

Why not switch to a ONE per day capsule like BariatricPal Multivitamin ONE for your Multivitamin? You can follow your meal plan and get your exercise in, but you are selling yourself short if you are trying to lose weight without taking your vitamins! BariatricPal Multivitamin ONE capsules can help prevent the nutrient deficiencies that are all too common after bariatric surgery. With just one convenient & affordable BariatricPal Multivitamin ONE capsule each day, you can get the vitamins and minerals you need to stay healthy!* The vitamins and minerals in BariatricPal Multivitamin ONE may help: Maintain normal metabolism and energy. Promote healthy bones, joints, blood, and heart. Support normal mood. Support healthy wound healing and immunity. Maintain cellular integrity and antioxidant functions. Promote healthy hair, skin, and nails. BariatricPal Multivitamin ONE was designed and developed by a team of the world's leading Bariatric medical professionals. The fast-dissolving small veggie capsules are very easy to swallow and use. You only need one a day to meet recommendations for bariatric patients. BariatricPal Multivitamin ONE is based on the latest post-op guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS) to provide over 20 vitamins and minerals. BariatricPal Multivitamin ONE is especially high in nutrients such as iron, vitamins B12 and D, folic acid, and biotin, that are known to be at risk for bariatric surgery patients. Specifically formulated according to ASMBS recommendations not to contain calcium to avoid interference with iron absorption. BariatricPal Multivitamin ONE Highlights: 100% of the daily value for 20 essential vitamins and minerals. Formulated based on the latest ASMBS guidelines. One small convenient capsule daily. Gluten-Free, Dairy-Free, Soy-Free. Fast-dissolving veggie capsules. Made in the USA. Easy to swallow. Affordable. BariatricPal Multivitamin ONE "1 per Day!" Bariatric Multivitamin Capsule is also available in an Iron Free version here. Designed for patients that have undergone weight loss surgery such as RNY Gastric Bypass, Gastric Sleeve, Duodenal Switch, and other malabsorptive weight loss surgery procedures. Available in 30-count or 90-count bottles, with or without Iron! *Please take a calcium supplement separately to prevent interference with absorption of iron.

Detour makes protein bars so insanely delicious, you can’t wait to devour them. And they take their nutrition just as seriously, starting with high quality, complete whey protein. Find the Detour protein bar that fits you at the BariatricPal Store!

If you had surgery with Dr. Mario Almanza, Weight Loss Agents or any other surgeon at Grandview Hospital in Tijuana, México after August 2018, it’s recommended by the Pan American Health Organization / World Health Organization (PAHO/WHO) that you should be tested for hepatitis B, hepatitis C and HIV. Please read https://www.who.int/csr/don/5-march-2019-carbapenem-resistant-p-aeruginosa-mex/en/ for more detailed information. “A local investigation at Grand View Hospital identified reusable equipment that was not being appropriately processed, which poses a small but potential risk of transmission for bloodborne infections among patients.” There are some amazing surgeons and hospitals in Mexico. PLEASE do your research before selecting any surgeon in any country!!!

Local patient run WLS support groups are fantastic but most don't have a long lifespan. BariatricPal started almost 100 local meetups a few years back and almost none are still around today.

“Complete” But Lacking Essential Nutrients What does a “complete” multivitamin contain? It could provide anything from all the essential nutrients to just a few. There is no legal definition for “complete.” In the case of Flintstones “Complete” multivitamin chewables, “complete” apparently means that it has all 13 vitamins, but only 6 of the more than 15 essential minerals that you need. Quantity Is Critical For bariatric surgery patients, it is not only important to get each of the necessary vitamins and minerals, but also to have the right amounts. You need high amounts of some of the vitamins and minerals, and Flintstones chewables simply do not deliver. For example, the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests at least 12 mg thiamin (vitamin B1) per day, while a chewable has 1.5 mg. You will also be short on: Vitamin A Vitamin D Vitamin E Vitamin B12 Iron Calcium And more. “Doubling Up” Does Not Work If one tablet is not enough, can’t you just take two? Well, not really. First, getting twice as much as certain nutrients may still leave you short. For example, 2 Flintstones chewables provide 1,200 IU of vitamin D, while recommendations for post-op gastric bypass patients are to get 3,000 IU per day. And no matter how many chewables you take, you will never get enough of essential minerals such as selenium and chromium, since the chewables have none. Multivitamin: What Is in a Name? We usually refer to them as “multivitamins,” but most often, we really mean, “multivitamin and mineral supplements.” Sometimes, a “multivitamin” that you buy off the shelf really is literally a bunch of vitamins with few or no minerals. Do not get confused by the name when purchasing your supplement. Read the supplement facts label to see which nutrients are in the supplement, and how much there is. Safe Choices, Your Way To be sure that you are getting the right supplement for bariatric surgery post-op needs, you are best off choosing a bariatric supplement. It may be a tad more expensive, but it could prevent deficiency diseases such as anemia or peripheral neuropathy. The BariatricPal Store has Multivitamin One and a wide range of other multivitamin and minerals formulated according to ASMBS guidelines. Choosing a bariatric surgery-targeted multivitamin instead of a kids’ supplement does not mean you have to choke down capsules if you cannot stand them. You can always opt for another form, such as Powder or a Soft Chew. BariatricPal Protein One has 28 essential vitamins and minerals, along with protein and fiber, in Unflavored powder or great-tasting shakes such as Chocolate, Vanilla, Cookies and Cream, Peanut Butter, Chicken Soup, and more. For help figuring out which vitamin and mineral supplement may be right for you, you can look at the attached ASMBS guidelines or check out our Bariatric Vitamin Guide, which breaks down recommendations for each surgery type. Also, be sure to talk to your doctor about your individual needs before trying a supplement. ASMBS-Nutritional-Guidelines-2016-Update.pdf

Dr. Ren or Dr. Fielding at NYU. See LapBand.com for a surgeon locator.

We've received verified reports that Dr. Jaime Ponce de Leon is operating at Grand View Hospital after the recent CDC warning and WHO warning on Drug-Resistant Infections! More recently, the Public Health Agency of Canada has also issued warnings about using this hospital and associated surgeons. We're very disappointed at Dr. Poince's decision to put patients at risk for this life-threatening infection. There are some amazing surgeons and hospitals in Mexico. PLEASE do your research before selecting any surgeon in any country!!!

I've been using the same Yunmai "mini" Wireless Bluetooth Smart Scale with 10 Body Measurements for at least 2 years. The app is awesome and it's only $34.99 at the BariatricPal Store.

How far are you out of surgery? Generally, you're allowed caffeine 30 days post op. Definitely, follow your surgeon's instructions. According to the ASMBS: Q Do I need to avoid caffeine after bariatric surgery? A: Caffeine fluids have been shown to be as good as any others for keeping you hydrated. Still, it is a good idea to avoid caffeine for at least the first thirty days after surgery while your stomach is extra sensitive. After that point, you can ask your surgeon or dietitian about resuming caffeine. Remember that caffeine often comes paired with sugary, high-calorie drinks, so be sure you’re making wise beverage choices. Are you taking your vitamins?

Why don't you take an all in one multivitamin that has all the B12 you require and doesn't have any taste?

For sure! I have Bypass and use BariatricPal Multivitamin ONE "1 per Day!" Bariatric Multivitamin Capsule with 45mg Iron. Ask your surgeon but you should be fine with a capsule. I was taking them the week after surgery without any issues. All surgeons allow Bypass patients to take capsules 30 days post op.