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Schmincke

Gastric Sleeve Patients
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Everything posted by Schmincke

  1. Schmincke

    Post op Diet...please help!

    I think milk is the least expensive protein liquid. My NUT suggests making double protein milk by adding 1/4 cup powdered skim milk to a cup of skim milk. But if you are lactose intolerant, this would not be helpful. I have not discovered any truly unflavored protein powder but I am enjoying a wide variety of protein smoothie flavors using vanilla whey protein, no-sugar almond milk, and flavoring like powdered coffee, cinnamon, vanilla, 1/4 cup fruit, a piece of banana, vanilla or peppermint or run extract, sugar-free syrup, etc. Some people (not me) like Unjury chicken broth which is protein enriched. Good luck!
  2. Schmincke

    HELP!....HAIR LOSS !

    Are you getting at least 80 grams of protein a day? My NUT warned us that unless we take our vitamins AND our protein we will experience a lot of hair loss.
  3. Schmincke

    New here!

    Welcome Molly! I love the support and information that I get on this site and I hope you do too. Sounds like you are off to a great start! Keep up the great work.
  4. Schmincke

    Surgeon has only done 26 sleeves

    Consider this abstract - malpractice lawsuits are more common with inexperienced surgeons: Surg Obes Relat Dis. 2014 Jan-Feb;10(1):121-4. doi: 10.1016/j.soard.2013.04.015. Epub 2013 Jun 11. Bariatric-related medical malpractice experience: survey results among ASMBS members. Dallal RM1, Pang J2, Soriano I2, Cottam D3, Lord J4, Cox S5. Abstract BACKGROUND:The medicolegal aspects of bariatric surgery are very difficult to analyze scientifically because there is no central, searchable database of closed case claims and little incentive for malpractice insurers to divulge data. Examining medicolegal data may provide insight into the financial and psychological burden on physicians. Detailed data also may be used to improve patient safety and determine common causes of negligence. METHODS:All U.S.-based members of the American Society of Metabolic and Bariatric Surgeons were asked to complete a survey regarding their bariatric-related medical malpractice experience. RESULTS:Of the 1672 eligible members that received the survey, 330 responded (19.7%). Mean years in practice was 15.3±9. Mean annual cost of malpractice insurance was $59,200±$52,000 (N = 197). The respondent surgeons experienced 1.5±3.2 lawsuits on average over the course of their practice. Of the 330 respondents, 144 (48%) did not report a bariatric-related lawsuit filed against them. Of the 464 lawsuits reported by 156 surgeons, 126 were settled out of court (27%), 249 were dropped (54%), and 54 (18%) went to trial. Seventy-two percent of cases that went to trial were found to be in favor of the defense. The mean lifetime amount paid for suits was $250,000±$660,000. The probability of a bariatric surgeonexperiencing a lawsuit was independently associated with the years in practice (P = .03) and number of total cases thesurgeon has performed (P = .01). The annual cost of malpractice insurance was independently predicted by the amount paid in previous claims (P = .01). CONCLUSIONS:The probability of a medical malpractice lawsuit correlates positively to the number of proceduresperformed and the number of years the surgeon has been in practice.
  5. Schmincke

    In my 2nd Stall!

    It was good to read this thread. I am in a stall too. It's probably because I started working out harder. Thanks for the encouragement, everyone. JessRose, I hope your stall is short!!
  6. Schmincke

    New here!

    Welcome Sami! I have found this site really, really helpful and there are some terrific supportive friends who you will meet here. Good luck to you!
  7. Schmincke

    Reflux and Sleeve?

    It may not be reassuring but here are two very recent abstracts on the topic, suggesting that worsening of reflux is very common unless there is hiatal hernia repair performed too. The first abstract simply reflects the experience at one newly-opened center so its results may have more complications than would be seen with very experienced surgeons, especially at a Bariatric Center of Excellence: BMC Surg. 2014 Feb 11;14(1):8. doi: 10.1186/1471-2482-14-8. Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study. Våge V1, Sande VA, Mellgren G, Laukeland C, Behme J, Andersen JR. Abstract BACKGROUND:To evaluate changes in obesity-related diseases and micronutrients after laparoscopic sleeve gastrectomy (LSG). METHODS:We started the procedure in May 2007, and by December 2011, 117 patients could be evaluated for a two year follow-up. Comparisons of preoperative status with 12 and 24 months postoperative status were made for body mass index (BMI), obesity-related diseases and micronutrients. RESULTS:Major complications included bleeding requiring transfusion at 5.1%, leak at 1.7% and abscess without a visible leak at 0.9%. Mean BMI was reduced from 46.6 (standard deviation (SD) 6.0) kg/m2 to 30.6 (SD 5.6) kg/m2 at two years, and resolution occurred for 80.7% of patients with type 2 diabetes, 63.9% with hypertension, 75.8% with hyperlipidemia, 93.0% with sleep apnea, 31.4% with musculoskeletal pain, 85.4% with snoring and 73.3% with urinary incontinence. Amenorrhea resolved in all premenopausal females. The proportion of patients with symptomaticgastroesophageal reflux disease increased from 12.8% to 27.4%. The prevalence of patients with low ferritin-levels increased, while 25-hydroxyvitamin D (25(OH)D) deficiency decreased postoperatively. CONCLUSIONS:LSG is an effective procedure for morbid obesity and obesity-related diseases, but the technique should be further explored particularly to avoid gastroesophageal reflux. Free PMC Article Expert Rev Gastroenterol Hepatol. 2014 Mar 3. [Epub ahead of print] The effects of sleeve gastectomy on gastro-esophageal reflux and gastro-esophageal motility. Hayat JO1, Wan A. Abstract Sleeve gastrectomy is an increasingly performed bariatric procedure associated with low morbidity and good short to medium term effects on weight loss and comorbid conditions. Studies assessing the prevalence of post-operative gastro-esophageal reflux disease (GERD), show sleevegastrectomy may provoke de novo GERD symptoms or worsening of pre-existing GERD. Pathophysiological mechanisms of GERD after sleevegastrectomy include a hypotensive lower esophageal sphincter, increased gastro-esophageal pressure gradient and intra-thoracic migration of the remnant stomach. A reduction in the compliance of the gastric remnant may provoke an increase in transient lower esophageal sphincter relaxations. Time-resolved MRI suggests relative gastric stasis in the proximal remnant and increased emptying from the antrum. A lack of standardisation of technique, along with heterogeneity of studies assessing GERD may explain the wide variability in reported results. Simultaneous and careful repair of an associated hiatus hernia may result in a reduction in the prevalence of post-operative GERD.
  8. Schmincke

    so embarrassing!

    Panty liners or pads!
  9. Schmincke

    Jan 13, 2014 Sleeved Friends

    Non Sleeve Victory: my new pants are size Large instead of Extra Large. Yahoo!
  10. Schmincke

    Driving...Post Operation

    It takes a while for the anaesthesia to get out of your system before you are safe to drive. It partly depends on the drugs they give you. You could phone your doctors' office and ask.
  11. Schmincke

    Psoriasis remission?

    Many (but certainly not all) bariatric patients experience improvement of autoimmune diseases after surgery. What a wonderful side effect!
  12. Schmincke

    Kids stressing me out!

    Maybe she knows you are busy losing weight and just wants attention? Mine used to throw a tantrum every time I got on a long distance call to my mum.
  13. Schmincke

    Pre-Op diet?

    My doc did not need me to follow the liver shrinking preop diet but I did anyway. Eating healthy can't be bad!!
  14. I was on an ACE inhibitor and a diuretic before surgery. When I was discharged the doc took me off the diuretic. Still taking the ACE inhibitor but probably off it in another 10-20 pounds.
  15. His decision opened the door for me to be brave enough to discuss weight loss surgery with my DH. I finally chose the sleeve not the band. Even though I am not a fan of Christie politically, I must credit him with getting me moving on what has become one of the best decisions of my life. Bravo Gov Christie.
  16. Schmincke

    Is my Trainer kidding me!

    RJ, I thought I could never do those moves when I started. Within a couple weeks I could and they just got easier every time. I weighed about 220 at the time. I never, ever thought that exercising could be fun, but after a while it was - and I missed it if I could not! So hang in there, you can do it.
  17. Try not to eat all your protein so early. My NUT says to have some protein every 4 hours. There is some evidence that you do not absorb protein as well if you eat it all at once. Also spreading it out will keep head hunger away.
  18. Schmincke

    Motrin?

    Motrin (ibuprofen) and all other NSAIDs as well as aspirin are discouraged if not prohibited by most bariatric surgeons after surgery (usually for life) except in very select circumstances. Tylenol (acetaminophen) is the OTC painkiller of choice after bariatric surgery. It is not as good an anti- inflammatory, but it does not mess with the stomach lining either.
  19. Schmincke

    Be careful. ..

    How about "my doctor suggests I lose x more pounds" if you really get cornered?
  20. Schmincke

    Sex question

    My doctor said 10 days as long as I felt well and was rested.
  21. Schmincke

    Jan 13, 2014 Sleeved Friends

    I am down 19 pounds since surgery, 24 since pre-Surg diet. The past few days, I find that my appetite and stomach capacity have started to creep up. Foods that I could not eat post-op are starting to be okay. Yesterday I had a small nibble of my friend's b-day cake. I tracked it, sure, and was within my goals for the day but ... Feeling a bit more normal, whether that is a good thing or not. Very glad of Fitnesspal right now as it holds me accountable!
  22. Schmincke

    Calorie Question

    I am past pureed, on soft foods like fish and veggies and fruit. I rarely get past 600 calories a day. Don't worry too much about it. What you really need to watch is (1) did you get all your fluids today (60 oz+)? (2) did you get all your Protein today (60 gm +)? (3) did you stay away from junk today? (Eat protein first, then veggies/fruit, then if there is any space left, carbos) If the answer to all three is Yes, then you should be on track, and losing weight. Maybe not weighing less every single day - and sometimes stalling for a while - but on the slow-and-steady path to a healthy weight.
  23. Schmincke

    January 2014 Sleevers Come In!

    I do not like the Unjury products. They have a great return policy, fortunately, because I bought a big shipment and am returning almost everything. I like Premier protein shakes from Costco or Sam's Club. I like Muscle milk powder. I like Target's house brand vanilla protein powder too.
  24. Schmincke

    Recovery time

    I took 4 weeks and did work some from home during that time. Some people take even longer. Everyone is different.
  25. Schmincke

    Dangers of Sugar Free - how much is too much?

    The only sweeteners that I consider natural are the ones that are in their natural form in fruits and veggies. And they are probably the safest ones. They have also never caused me to do any compulsive eating. I did not get fat eating grapes. The artificial sweeteners that I am most afraid of are sugar and corn syrup. Both are manufactured and both are demonstrated to be dangerous to someone like me. They got me into this position - them and other simple carbohydrates plus my own compulsions. So I try not to go near them. I don't trust myself around them.

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