Last week I went to my three year surgery follow up at Kaiser Fremont. It was a group appointment that took a couple of hours and included talks by our Bariatric Medical Doctor, Bariatric Psychologist, Bariatric Nutritionist, and Bariatric Surgeon. If you needed one on one appt, they scheduled those after. Kaiser does a great job with education. There were a lot of good handouts and good information shared.
Some highlights:
From the Surgeon:
When people get a revision, weight loss is only around 10 lbs., which the surgeon credited to the liquid diet followed before and after surgery. He said they don’t know why there is not substantial weight loss with the revision surgery, but he theorized that whatever was reset during the first operation was a one time thing.
He also showed an image of stomach and how blood flow to the stomach is decreased with each operation. I hadn’t realized how many veins and arteries were connected to the part of our stomach that is removed. A lot!
The stomach can only stretch so much. It does not continue stretching once it gets to maximum capacity. People may think they are eating more at one time because the brain adapts.
Ulcer is leading cause of death in long term complications. Ulcers are caused by too much alcohol, smoking, and some drugs, including SSRIs, immunosuppressors and the usual suspects. Not spicy or acidic foods.
From the medical doctor:
Kaiser Vitamin recommendations have changed. For the latest, along with the latest Kaiser Bariatric Surgery Guidebook, see: Iron in Ferrous Sulfate form can cause stomach upset, that’s why they recommend Ferrous Fulmanate or Ferrous Gluconate. Take with stool softener if needed.
Watch for birth control pill malabsorption.
For those that don’t like pills, she offered the following schedule:
Morning: Wellese liquid Calcium or calcium citrate chews, multi with iron
Evening: Wellese liquid calcium or calcium citrate chews, multi with iron
Weekly: 5000 mg B12, 250 mg B1, Iron with Vitamin C
Once per month: 50,000 iuVitamin D
From the Psychologist:
Tip for eating less: Do not put serving plates on table. People eat more then. Serve from kitchen so people don’t see extra food and have to get up to have a second helping.
Cross addiction is more common in year two than year one post op.
She had a whole list of books for us, but strongly recommended Mindess Eating by Brian Wansin.
She had a handout from AmiHungry.com for Mindful Eating After Bariatric Surgery. Download it here: Water, etc.
From the Nutritionist:
Eat 20-25 grams of Protein per meal (70 grams per day). 3-5 planned meals per day, 1200-1500 calories per day, limit carbs to 30 per meal (15 carbs average in 1 starch, dairy or fruit).
Eat protein first, then up to ½ cup veggies, then carb such as whole grain, fruit or dairy.
Eat protein with any foods with higher sugar content. For example, have some cheese with grapes.
Iron in Ferrous Sulfate form can cause stomach upset, that’s why they recommend Ferrous Fulmanate or Ferrous Gluconate. Take with stool softener if needed.
Water, etc.