Alex Brecher

Paperwork and Documentation Photo ID. Credit card, checkbook, and/or cash. List of contacts. List of questions and notebook to take notes. Insurance card, letter of reimbursement acceptance, or any other paperwork. A list of your medications. Passport or passport card Visa Bring a photo ID and any money you will need. You may not need any if you are going to a local hospital and your insurance covers your surgery. You may need a lot if you are self-pay and payment is due at the time of service. Bring money for any incidentals, such as a taxi ride home or to the airport. Bring any insurance paperwork you have if your insurance is helping to cover your surgery. Also bring a list of contacts such as family and friends that you can call if you need help. Include your doctor on the list. You or your surgeon may need to ask about medical conditions or medications that you are on. You need to bring the proper documentation if you are going outside the country for your bariatric surgery. At the least, you need a passport or passport card, and to be on the safe side, you should be sure it expires at least 6 months after your scheduled return date. You may need a visa for some countries, although not for Mexico if you are American. Clothing Slippers or socks with non-slip rubber soles or grips. Loose-fitting clothes to wear home. A change of underwear. You will wear the hospital’s gown, but should bring something loose-fitting to wear when you are discharged. Be sure the waist is very loose and the outfit is easy to slip on since you will be in some pain and will not be very agile after surgery! A gown or dress can be best. Non-slip slippers or socks will let you walk around when you can without needing to put on shoes and without risking falling when you are tired and weak. Do not take expensive clothes, tight fitting clothes, or accessories. Toiletries Toothbrush, toothpaste, deodorant, soap or body wash, shampoo, and conditioner. Lip balm and lotion or Vaseline. Hair ties. Baby wipes Just take the basics. Keep your teeth clean, and take what you need for a shower, if you have time to take one. You might feel very dry after surgery. Lip balm can keep your lips from getting too chapped, while lotion can keep your skin moisturized. A scrunchie or elastic hair band can keep your hair out of your face if you have long hair, and baby wipes can help you freshen up without much effort. Go light with your toiletries. Do not bother taking makeup since you will not have time to put it on, and you probably will not have the energy, either! Electronics and Entertainment Phone and charger. Book or eReader with books on it. Crossword puzzles or other paper or electronic games. Movies. Do not forget your charger for each device! Time will probably pass very quickly in the hospital and you may not have a chance to get to any of your entertainment. You may also be too tired or distracted to focus on it. Food and Drink Tea bags and water enhancers. Protein powders and shakes. Water bottle. Protein blender bottle. Your first priority after weight loss surgery will be to stay hydrated. Water can taste funny, so you might want to pack some water enhancer powder or flavor drops. Decaffeinated herbal tea bags are easy to pack, too. Just make sure you let the tea cool before you sip it so it does not hurt your surgery scar. A water bottle and protein blender bottle can be useful for the trip home. You do not need to take any solid food since you will not be eating it for several days to weeks after weight loss surgery. For Your Health and Comfort Pillow. Medications. Ear plugs and face mask. CPAP machine. Gas-X. Throat lozenges. A pillow on your lap can make your ride home much more comfortable. It can also help you sleep better in the hospital if you are fussy. Ask the hospital about which medications to bring, whether you should bring your own CPAP machine, and how they feel about you using GAS-X to combat your post-op flatulence. Do Not Bring Jewelry. Irreplaceable keepsakes, such as photos. A simple rule of thumb is if you do not need it and do not want to lose it, do not take it. This goes for pricey items, such as designer handbags and jewelry, and for anything irreplaceable, such as family photos.

Seems like they've been discontinued. I just bought a case via eBay for our patients. Check out eBay. I see they still have them.

Some patients need to jump through hoops to get weight loss surgery. You are especially bound to the requirements if you are hoping for reimbursement from your health insurance plan or if your chosen surgeon has strict requirements. A long weight loss diet or liquid diet are some of the better known requirements, and others include a sleep study, cardio testing, lab testing, and psychiatric evaluations. The purpose is to make sure you are dedicated to weight loss surgery success and properly prepared for it. However, these requirements are not just annoying for some patients. They may actually be counterproductive! In fact, a recent study showed that having more requirements leads to patients deciding not to get surgery. This means people who need it might be left out of bariatric surgery. What do you think about pre-op requirements? Are they helpful? Were you required to have a long pre-op diet and go through a variety of tests? Did you think they were useful, or a barrier? Would you consider going self-pay just to avoid the hoops? Share your thoughts here!

I just posted a packing list to our WLS Magazine 7 hours ago! Check it out!!

Your weight loss surgery is scheduled. You have your pre-op diet instructions and you are preparing your kitchen and house for your recovery. You are scheduling your transportation to the hospital and home. There is a lot to think about, and packing for the hospital is something else to add to the list. When you pack right, you have everything you need without having extras to weigh you down. Keep packing from adding to your stress with this handy list of essentials, nice-to-haves, and absolutely-nots! Paperwork and Documentation Photo ID. Credit card, checkbook, and/or cash. List of contacts. List of questions and notebook to take notes. Insurance card, letter of reimbursement acceptance, or any other paperwork. A list of your medications. Passport or passport card Visa Bring a photo ID and any money you will need. You may not need any if you are going to a local hospital and your insurance covers your surgery. You may need a lot if you are self-pay and payment is due at the time of service. Bring money for any incidentals, such as a taxi ride home or to the airport. Bring any insurance paperwork you have if your insurance is helping to cover your surgery. Also bring a list of contacts such as family and friends that you can call if you need help. Include your doctor on the list. You or your surgeon may need to ask about medical conditions or medications that you are on. You need to bring the proper documentation if you are going outside the country for your bariatric surgery. At the least, you need a passport or passport card, and to be on the safe side, you should be sure it expires at least 6 months after your scheduled return date. You may need a visa for some countries, although not for Mexico if you are American. Clothing Slippers or socks with non-slip rubber soles or grips. Loose-fitting clothes to wear home. A change of underwear. You will wear the hospital’s gown, but should bring something loose-fitting to wear when you are discharged. Be sure the waist is very loose and the outfit is easy to slip on since you will be in some pain and will not be very agile after surgery! A gown or dress can be best. Non-slip slippers or socks will let you walk around when you can without needing to put on shoes and without risking falling when you are tired and weak. Do not take expensive clothes, tight fitting clothes, or accessories. Toiletries Toothbrush, toothpaste, deodorant, soap or body wash, shampoo, and conditioner. Lip balm and lotion or Vaseline. Hair ties. Baby wipes Just take the basics. Keep your teeth clean, and take what you need for a shower, if you have time to take one. You might feel very dry after surgery. Lip balm can keep your lips from getting too chapped, while lotion can keep your skin moisturized. A scrunchie or elastic hair band can keep your hair out of your face if you have long hair, and baby wipes can help you freshen up without much effort. Go light with your toiletries. Do not bother taking makeup since you will not have time to put it on, and you probably will not have the energy, either! Electronics and Entertainment Phone and charger. Book or eReader with books on it. Crossword puzzles or other paper or electronic games. Movies. Do not forget your charger for each device! Time will probably pass very quickly in the hospital and you may not have a chance to get to any of your entertainment. You may also be too tired or distracted to focus on it. Food and Drink Tea bags and water enhancers. Protein powders and shakes. Water bottle. Protein blender bottle. Your first priority after weight loss surgery will be to stay hydrated. Water can taste funny, so you might want to pack some water enhancer powder or flavor drops. Decaffeinated herbal tea bags are easy to pack, too. Just make sure you let the tea cool before you sip it so it does not hurt your surgery scar. A water bottle and protein blender bottle can be useful for the trip home. You do not need to take any solid food since you will not be eating it for several days to weeks after weight loss surgery. For Your Health and Comfort Pillow. Medications. Ear plugs and face mask. CPAP machine. Gas-X. Throat lozenges. A pillow on your lap can make your ride home much more comfortable. It can also help you sleep better in the hospital if you are fussy. Ask the hospital about which medications to bring, whether you should bring your own CPAP machine, and how they feel about you using GAS-X to combat your post-op flatulence. Do Not Bring Jewelry. Irreplaceable keepsakes, such as photos. A simple rule of thumb is if you do not need it and do not want to lose it, do not take it. This goes for pricey items, such as designer handbags and jewelry, and for anything irreplaceable, such as family photos.

I am trying to research if our members prefer organic, non-GMO based Protein supplements or if you honestly don't care for them. Please assist me by responding to the poll explaining why you responded yes or no to the poll.

He's a very well-respected surgeon. His wife (Dr. Christine Ren-Fielding) was my surgeon as well back in 2013. Dr. Fielding has done a few fills for me over the years. I had surgery at NYU as well and have never seen Northern Westchester Hospital. Let us know how it went!

I was wondering the same! We are developing a brand new BariatricPal app. What other features and trackers do you feel are important to post-op weight loss surgery patients that Baritastic doesn't already offer?

We should see the results of this PatchMD study in a month or two.

Starbucks debuted its Unicorn Frappuccino amidst much fanfare. The chain advertises its drink as a way of bringing the mythical animal from its hiding places in enchanted forests to real life as customers enjoy the imaginative blend. It is a drink that starts out purple with blue swirls, and changes to pink as you swirl it. Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page! Does This Drink Make My Butt Look Big? Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind. Sugar for a Day…or Week The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association. Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal. Where Is the Protein? As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice Beware Dumping Syndrome Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom! Delicious and Nutritious Alternatives Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!

I'm in Tijuana at the moment and found out that there's been another Patient Death at A Lighter Me (ALM) with Dr. Jose Luis Curiel Marchena . The patient death occurred about 3-4 weeks ago. I found out about this from my contact at the US Consulate here in Tijuana.

Nobody called you a bad guy or gal. I reported information that was relayed to me by a trustworthy source. You denied the death as long as you were able. That was until your own patient posted that she was there when the patient died. Was there a death or not? The details definitely make a difference but the core issue is you're trying to brush away the fact that a patient passed away while under your company's care. What else are you hiding that we aren't privy to or that wasn't leaked to us by a well-informed source? It would have been a lot simpler if you wouldn't act shady and just tell it as it is. You don't think I was in TJ? For transparency purposes, here's my Jetblue itinerary: I was in TJ. I'm normally there a week at a time every month or so. We have 9 pages of posts but you've yet to confirm or deny if a patient actually died after being operated on by Dr. Jose Luis Curiel Marchena at A Lighter Me? Yes or No?

It's a YES or NO question. Are you denying a patient died?? This is about bringing transparency to an industry that needs some cleaning up. Your own patient posted in this topic that they were in the hospital when your ALM patient passed away. I'm not sure how much more you're going to try to twist things and make them about me.

Success after weight loss surgery is no accident. It is the result of a lot of hard work and careful planning on your part. While of course it depends on a skillful surgeon, your post-op success depends most heavily on you. You can begin to set yourself up for satisfying weight loss and preventing regain long before your surgery date. Here are some ideas for building that solid foundation that will make your weight loss surgery journey smoother and more satisfying. Choose the right surgeon. If weight loss surgery is the tool, your bariatric surgeon is the one who makes the tool and gives it to you. You want a tool that is made precisely, ready to do the job, and built to last. Your surgeon needs to make the right cuts and place the band properly or make a tight, solid sleeve or pouch. So, look for a surgeon who is experienced and has a good track record of successful patients and low complication rates – don’t be afraid to ask! There’s more to choosing a surgeon than technical skills. Also, consider what else the surgeon will do for you. The right surgeon for you is willing to discuss your options and the procedure with you in a way that you can understand. You’re setting yourself up for extra challenges if you’re afraid to talk to your surgeon or your surgeon is unavailable. Get the scoop on the diet. Your diet is central to every part of the weight loss surgery journey. You may be told to lose some weight before surgery as a test to make sure you’ll follow the rules post-op. Then there’s the pre-op liquid diet to shrink your liver for a safer surgery. Next, for faster healing and fewer side effects, you need to follow the post-op progression from liquids to pureed foods to solid foods. Finally, there’s the nutrient-dense, low-calorie diet to help you hit goal weight and stay there. At best, you will have a surgeon or a nutritionist who gives you plenty of information. Since that’s not always the case, you may need to take steps to figure out the diet for yourself. You can look online, and may need to shell out the money for a few appointments with a nutritionist. Not knowing the right foods to eat can set you up for surgery complications and disappointing weight loss. Take responsibility. It’s nice to depend on a stellar surgeon and complete healthcare team to walk you through surgery and beyond step by step. Ideally, your trusted surgeon would explain your options to you and recommend the best surgery for you, whether it’s the sleeve, band, bypass, or another choice. You’d go back for follow-up appointments and ongoing nutritional and psychological counseling. That doesn’t always happen in the real world, but that’s no excuse to give up. You can take responsibility for finding out the information you need to know about what to expect, how to prepare, and what comes next. Be persistent and do your research in all kinds of places, and you’re more likely to succeed. Face the facts. Weight loss surgery isn’t all fun and games. You don’t leave the operating room skinny. Weight loss isn’t steady. It may take you longer to get to goal weight than you hoped. Recognize the real possibilities to avoid being disappointed and possibly even giving up. These are some other possibilities to consider, so you can be prepared if they happen to you. You may still love sugar, salt, fat, and/or starch. You may still be hungry. Others may not notice your weight loss, or may not be impressed. Others may be jealous of your weight loss or say you didn’t earn it. You may have loose skin when you are finished losing weight. Weight loss surgery doesn’t solve psychological problems. Be Open-Minded If you want to lose weight and get healthy, you’ve got to change your diet. Whatever eating habits got you to this point are not going to get you to goal weight! That may mean you need to be open-minded. Maybe you hated vegetables, or can’t stand the thought of downing protein shakes for 2 weeks on the pre-op liquid diet and up to 4 weeks on the post-op liquid and mushies diets. It’s time to re-evaluate. Can you sneak some veggies into your diet? Can you retrain your brain to love them? Can you force down those protein shakes for a few weeks in exchange for a lifetime’s worth of better health? Learn to see the good. There will be disappointments - guaranteed. The scale may not cooperate, or you may make a poor eating choice, or you might skip your morning workout because you didn’t make sleep a priority the night before. Focus on the negative, and you just may talk yourself out of continuing the hard work and good progress. Instead, learn to appreciate yourself and see the positive sides of things. Maybe you didn’t lose weight this week, but did you eat right? Maybe you downed a piece of pepperoni pizza without thinking about it, but did you pass up the breadsticks and soda that you would have had before surgery? Maybe you didn’t work out this morning, but did you make it to the gym more this month than you did last month? See yourself as a strong, powerful person, and you will act like one. You can build on the positive behaviors you see in yourself so they eventually overshadow the mistakes. You have control over your own destiny. Success with weight loss surgery depends on planning and hard work. The more you are involved and the more responsibility you take throughout the process, the better you can do.

I am keeping this up but removed the name of your surgeon.

ASMBS does allow international surgeons to be listed. Unless a surgeon practices in the US, there's really no purpose.

Great question! I am a Director-At-Large at the ASMBS and feel qualified to answer this question ASMBS is the "Amercian" Society of Bariatric Surgery. Dr. Illan is not an American surgeon and doesn't operate in the states. He is President of the Mexican Society. I'm attaching some recent certificates/credentials that aren't posted on the TeamMX site. @Bill Yanezcan explain them more in detail if you're interested.

If you are an overweight parent, the last thing you want is for your children to fight through the same weight battles that you have experienced. Unfortunately, chances are good that your children will be overweight, according to research published in the “Journal of Clinical Research and Pediatric Endocrinology.” If both parents are obese, each of their children has an 80% chance of being obese. The percent decreases to 40% if one parent is obese. What if both parents are of normal weight? Children have only a 13% chance of being obese. Overweight children are more likely to become overweight adults, and you know what a hard road that is to go down if you yourself have struggled with obesity. How can you keep your children healthy and prevent them from suffering from the physical and emotional problems that can happen as the result of obesity? These are some ideas for handling the situation in positive ways. Never Shame Them Do not blame your children for being overweight, or make them feel bad about themselves or their bodies. Always let them how proud you are of them and how much you love them. Overweight children need more support than ever if they are feeling different from their peers or even bullied at school. Pinpoint the Causes While it is easy to say, “It just happened,” or, “It is unavoidable,” the truth is more likely that you can identify some causes of your child’s weight problem. They might be happening at home or at school. Examples include: Not enough exercise – did you know kids are supposed to be active for 60 minutes a day? Too much junk food – how often do you opt for fast food for a quick meal while driving your children to activities, or send them to school with chips or a soda in their lunch because they are convenient? Too much screen time – a good limit is a total of 2 hours online or in front of a computer, television, or video game console. Offering dessert as a reward – never use food as a reward or imply that healthy foods are a chore to get through before dessert. Involve Your Pediatrician Doctors do not always recognize childhood obesity or know how to treat it. Bring it up if your child’s pediatrician does not directly address it. You may be entitled to extra help through your health insurance plan. Possibilities include nutritional counseling, enrollment in a weight control program, and sessions with an exercise physiologist. Be a Role Model It may not always seem like it, but children look up to their parents. You can help them out by modeling the healthy behaviors you want them to show. You can do that by following your weight loss surgery diet and exercise program – or eating right and being active, just like you want your children to do. Eat a proper breakfast, snack on fruit and vegetables, and make it a point to get active every day. By doing these things, you will help your children learn how to act healthy, as well as keep them from feeling isolated if you force healthy behaviors on them. You can also be a role model with your attitudes. Complain about your diet to your friends, not to your children. In front of your children, embrace your healthy lifestyle. Kids need to see how much fun you think it is to walk to the library or supermarket, how delicious you find that snack of peanut butter and apple slices, and how neat it is to pack a healthy lunch instead of taking money for the vending machine at school. Make It Easy Like you, kids will naturally choose the easy option. So, make the right choices the easy ones for them. Leave washed grapes and string cheese sticks in the fridge for them to grab quickly, and have a fruit bowl on the counter for easy access for snacks. Keep unhealthy treats out of the house or leave them out of sight so they are only for occasional times. Give Them Control Let your children be in charge as appropriate for their ages. You can give them options such as: “Do you want me to cook zucchini or broccoli in the tomato sauce?” “Do you prefer a salad or tomato soup with your sandwich?” “Do you want to shoot hoops would you rather walk to the library?” You can let older kids help you in the kitchen or pack their own lunches from among healthy choices that you offer. That way they can be proud of their own actions. You may have struggled with your weight for years, but that does not mean you cannot give your children a healthy start. Apply what you have learned throughout your weight loss surgery journey, keep a positive attitude, and stand with them the whole way, and your children can be as healthy as you want them to be.

Good point, agreed!

Betaine anhydrous is safe for most people. It can cause some minor side effects. These include nausea, stomach upset, and diarrhea. I suggest staying away from it post-op.

Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page! Does This Drink Make My Butt Look Big? Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind. Sugar for a Day…or Week The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association. Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal. Where Is the Protein? As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice Beware Dumping Syndrome Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom! Delicious and Nutritious Alternatives Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!

This Starbucks Unicorn Frappucino topic got me all heated up and inspired so I decided to write a quick article on it at the Weight Loss Surgery magazine!

Just an FYI. We already offer a discounted patch subscription service at the BariatricPal store.

You're an inspiration to us all. Congrats!!

Brooklyn, NY. Moving shortly to Inwood, NY (Long Island)