All posts by Dee Anne Agonis

February 5th, 2019 – HALT Emotional Eating

 One of the triggers for eating is our emotions.  We use food to soothe ourselves in many stressful situations, but it can be controlled with some awareness.  Dr. Coker talked about a simple way to clarify why we are eating called HALT:

            H – Hungry:     Do I need something physically or emotionally?  Find what will fill you.

            A – Angry:        What is causing me to feel this way?  Express yourself.

            L – Lonely:       Am I having difficulty connecting with others? Tell someone.

            T – Tired:         When was the last time I took a break? Breathe and slow down.

 

When you find yourself eating when you are not hungry, you need to stop and ask yourself if you are really experiencing one of the above feelings.  If you continue to eat during those times, you will find yourself on an emotional eating merry-go-round:

emotional wheel weight loss surgery kansas city

The problem with soothing ourselves with food is that that good feeling only lasts a moment, and then is replaced with guilt causing more stress and continuing the cycle.  Some common reasons for emotional eating are:

  • The feel good fix 
  • Prolong pleasure
  • Habit
  • Impulsive
  • Ignoring internal cues
  • Stress and effort to re-balance
  • Accessibility – it’s there
  • Sheer boredom
  • Distraction                                

In order to change our behavior we have to look at the steps involved in changing habits:

  1. Pre-contemplation – think about what you want to change and why
  2. Contemplation – figure out what you want to do instead
  3. Preparation – get yourself mentally ready and geared up to make the change; talk to someone about it, get support for making the change
  4. Action – make the change
  5. Maintenance – continue to work on keeping the change by rewarding yourself with non-food rewards.

In order to make the change, learn to “be” more aware of what is going on with you:

  1. SIT with your feelings. When you want to go eat, first do the following:
    • Stop –  just stop for a moment
    • Inspect – inspect your feelings and why your may be feeling hungry
      • (are you Hungry, Angry, Lonely or Tired)
    • Take a breath – once you have let the moment pass, address the real feeling you are having.
  1. Recognize your own negative self-talk. We have a lot of negative things we say to ourselves over and over. 
    • Name the critical voice – who is talking to you (is it something your mom, husband, friends says to you)
    • Be curious, not critical – why are they saying it
    • Is it true? – probably not
    • Distance yourself from the thought and shift the negative talk to how you wish to feel
    • You can begin to soothe yourself with positive self-talk
  1. Eat Mindfully. When you do eat, sit down, slowly chew, sense and savor the food, and smile!
  2. Consciously choose distraction during those trigger moments. Write down and keep handy:
    • 5 people to call
    • 5 ways to relax
    • 5 places to go calm down
    • 5 encouraging statements to tell yourself
    • 5 activities that will keep you otherwise busy and distracted

Food is not the enemy. Anger, sadness, regret and lack of self love are. 

Watch the TED Talk video on breaking habits at:

https://www.ted/com/talks/judson_brewer_a_simple_way_to_break_a_bad_habit

 

Why Take Journey Bariatric Multivitamins?

Many vitamins and minerals are essential for complete and balanced nutritional health. Even if you eat a balanced, whole-food diet, you may still be missing vital nutrients. Additionally, after weight loss surgery you are at higher risk for nutritional deficiencies. You require more vitamins than someone who has not had surgery due to less consumption of food and changes in your anatomy.

That is why taking a bariatric specific multi-vitamin is so important pre and post-surgery to ensure you are getting all essential nutrients. We have designed a bariatric multi-vitamin that is specifically formulated for weight loss surgery patients. Our Journey Multivitamin is easy to digest because we use ingredients that are highly absorbable. It is gentle on the stomach and is less likely to cause nausea and constipation due to specific ingredient selection.

Often, we get asked “Why can’t I just take a normal multi-vitamin?”. That is because each vitamin and mineral have specific daily values that need to be met and often your typical drug store multi-vitamin will not have the necessary amounts, leading you to buy additional supplements on top of your multi-vitamin. Our Journey Multi-vitamin is designed to ensure complete and balanced nutritional health for the bariatric patient because it includes the necessary vitamins and minerals, in the correct amounts, required for good nutrition.       

We also get asked, “What is the difference between your bariatric multivitamin and another bariatric brand?”. Our Journey multivitamin is the only bariatric multivitamin that has a probiotic in it. This aids in weight loss and gut healing. Additionally, many other bariatric multivitamins do not meet the standard amounts set by the American Society for Metabolic and Bariatric Surgery (ASMBS). This is the governing body of weight loss surgery in the US and implements quality control measures. Keep in mind that just because it says “bariatric” does not mean it meets the ASMBS standards. If you have questions about brands other than Journey please call us at 913-677-6319 and one of our dietitians will be able to answer any questions you have.

Below shows what you would need to buy to equal what is provided in the Journey Multivitamin:

**Costs are based upon Walmart’s Vitamin Selection.

Overall, our vitamins are more cost effective than purchasing vitamins at Walmart/Target/CVS/etc. Journey vitamins will also help you be more compliant with your vitamin regimen because you will be taking 2 pills verses 8 pills.  

Nutrition is the primary environmental trigger to a healthy weight, so that is why bariatric patients must take vitamins for the rest of their life. You will no longer be able to prevent nutritional deficiencies with food alone. Vitamins and minerals are essential factors in many biological processes that regulate appetite, hunger, nutrient absorption, metabolic rate, fat and carbohydrate metabolism, energy storage, and glucose balance. After weight loss surgery in Kansas City, there is a high risk of vitamin and mineral deficiency due to malabsorption and/or incomplete digestion of foods related to small amounts of gastric acid produced and dietary intake.

Here is a look at the most common deficiencies and how you can supplement your vitamin regimen with nutrient rich food sources.

Copper:  Copper is an essential mineral required by the body for bone and connective tissue production, and for coding specific enzymes that range in function from eliminating free radicals to producing melanin. A deficiency in copper can lead to osteoporosis, joint pain, lowered immunity, and since copper is essential for the absorption of iron, anemia.

DV: 2mg

  • Seafood 
  • Kale
  • Mushrooms
  • Seeds 
  • Nuts 
  • Beans 
  • Avocado
  • Goat cheese
  • Dried Fruit

Zinc/Folate: Zinc is a mineral that’s essential for good health. It’s required for the functions of over 300 enzymes and involved in many important processes in your body. It metabolizes nutrients, maintains your immune system and grows and repairs body tissues.

DV: Men: 11mg – Women: 8mg

Food:

  • Meat
  • Oysters
  • Crab
  • Lobster
  • Whole Grains
  • Legumes
  • Seeds
  • Nuts
  • Dairy

Iron: Iron Is Essential for Metabolism, Muscles, and Normal Bodily Functions. Iron gets used by the body to help make the hemoglobin in red blood cells, which then carry oxygen throughout the body, from our lungs to our muscles and other organs. It’s not a nutrient that you want to be lacking in. Not getting enough iron, a condition termed iron deficiency anemia (or just anemia), makes it difficult for your blood cells to deliver the oxygen your tissues and organs need.

DV: Men and Women Over 50: 8mg / Women 19 – 50: 18mg

Food:

  • Red Meat, pork, and poultry
  • Dark green, leafy vegetables – spinach and kale
  • Dried fruits – raisins and apricots
  • Peas, beans, and other pulses
  • Seafood
  • Seeds and Nuts
  • Egg Yolks
  • Poultry

Vitamin D: Vitamin D is important for good overall health and strong and healthy bones. It’s also an important factor in making sure your muscles, heart, lungs and brain work well and that your body can fight infection. Your body can make its own vitamin D from sunlight. You can also get vitamin D from supplements and a very small amount comes from a few foods you eat.

DV: 600 IU

Food:

  • Salmon
  • Canned Tuna
  • Mushrooms
  • Fortified Milk
  • Orange Juice
  • Fortified Yogurt
  • Swordfish
  • Eggs
  • Sardines

Potassium: High-potassium foods are an essential part of any balanced diet. The mineral helps regulate your body’s fluid levels, aids in muscular function and waste removal, and keeps your nervous system functioning properly.

DV: 4,700mg

Food:

  • Potatoes
  • Tomato
  • Kidney Beans
  • Fresh Fruit
  • Avocado
  • Fish
  • Acorn Squash
  • Dairy 
  • Dark Leafy Greens
  • Dried Fruit

Calcium: Calcium is a vital mineral. Your body uses it to build strong bones and teeth. Calcium is also needed for your heart and other muscles to function properly.

DV:  19-50: 1,000mg / 50 and Up: 1,200mg

Food:

  • Seeds 
  • Cheese 
  • Yogurt
  • Sardines and Canned Salmon
  • Beans and Lentils
  • Almonds
  • Whey Protein
  • Leafy Greens 
  • Edamame and Tofu
  • Milk
  • Figs

Magnesium: Magnesium is a nutrient that the body needs to stay healthy. Magnesium is important for many processes in the body, including regulating muscle and nerve function, blood sugar levels, and blood pressure and making protein, bone, and DNA.

DV: 400mg

Foods:

  • Dark chocolate
  • Avocados
  • Nuts
  • Legumes
  • Tofu
  • Seeds 
  • Whole grains 
  • Fatty fish
  • Bananas
  • Leafy Greens 

Vitamin B12: Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak.

DV: 2.4 mcg

Foods:

  • Clams
  • Sardines
  • Beef
  • Tuna
  • Fortified Nutritional Yeast
  • Trout
  • Salmon
  • Fortified Nondairy Milk
  • Milk
  • Yogurt
  • Cheese
  • Eggs

 

For additional nutritional information please feel free to call 913-677-6319 to schedule an appointment with one of our dietitians.

 

Sources:

https://www.healthline.com/nutrition/vitamin-b12-deficiency-symptoms

https://www.everydayhealth.com/hs/guide-to-essential-nutrients/common-nutrient-deficiencies/?slot=3&xid=nl_EHNLhealthyliving_2018-10-17&utm_source=Newsletters&utm_content=2018-10-17&utm_campaign=Healthy%20Living&eh_uid=83587720

https://www.myfooddata.com/articles/high-copper-foods.php

https://www.healthline.com/nutrition/copper-deficiency-symptoms#section5

https://www.healthline.com/nutrition/best-foods-high-in-zinc#section11

https://www.healthline.com/health/zinc-deficiency#symptoms

https://www.everydayhealth.com/pictures/best-food-sources-zinc/?slot=1&xid=nl_EHNLdiet_2018-11-01&utm_source=Newsletters&utm_content=2018-11-01&utm_campaign=Diet_and_Nutrition&eh_uid=83587720

https://www.everydayhealth.com/pictures/foods-high-in-iron/?eh_uid=83587720&slot=1&xid=nl_EHNLdiet_2018-12-06&utm_source=Newsletters&utm_content=2018-12-06&utm_campaign=Diet_and_Nutrition

https://www.healthline.com/nutrition/vitamin-d-deficiency-symptoms#section9

https://www.everydayhealth.com/foods-high-vitamin-d/?eh_uid=83587720&slot=4&xid=nl_EHNLdiet_2018-11-23&utm_source=Newsletters&utm_content=2018-11-23&utm_campaign=Diet_and_Nutrition#02

https://www.healthline.com/nutrition/potassium-deficiency-symptoms#section8

https://www.everydayhealth.com/pictures/foods-high-in-potassium/?eh_uid=83587720&slot=0&xid=nl_EHNLdiet_2018-12-12_15386936&utm_source=Newsletters&utm_content=2018-12-12&utm_campaign=Diet_and_Nutrition

https://www.healthline.com/health/calcium-deficiency-disease#prevention

https://www.healthline.com/nutrition/15-calcium-rich-foods#section16

https://www.healthline.com/nutrition/10-foods-high-in-magnesium

https://www.healthline.com/nutrition/magnesium-deficiency-symptoms#section9

https://www.healthline.com/nutrition/vitamin-b12-foods#section13

January 23, 2019 – Resolutions: Setting and Achieving Realistic Goals

Now that we are starting a new year, a lot of people make resolutions – about 60% of us make them, but only about 8% of us keep them.  Katie gave a brief overview of the history of New Year’s resolutions going back about 4000 years, when people started each year making promises to the gods.  A resolution is defined as “a firm decision to do or NOT do something,” that will improve your life in the coming year.

Why do so many of us fail?

  1. We go it alone
  2. We make lofty and unrealistic goals
  3. We give up too easily
  4. We have poor time management
  5. We don’t have a plan

Why should we make a resolution or set a goal?  Because setting resolutions gives you long-term vision with short term motivation.  It helps you focus and organize your time and resources.  So what do you want to achieve?  Set yourself up for success:

  1. Set goals that motivate you – the goal must be important to you and you see value in achieving it
  2. Set SMART goals: 
    • Specific  –  be specific so you know what the goal looks like
    • Measurable – your goal should be measurable, including dates, amounts
    • Achievable – make sure it’s something you are confident you can achieve
    • Relevant – goals need to be important to you
    • Time-based – set a deadline so you can celebrate success
  1. Set goals in writing – it helps to make it real
  2. Make an action plan and get support – you don’t want to be so focused on the outcome that you forget to plan all the steps you need to get there. Arrange your environment or routine to help support the goals, and then chart your progress – use a calendar to set out each step of the plan. If your goal is a common one, find a plan online or join a group so you have support.
  3. Stick with it! Build in reminders to keep yourself on track, and celebrate your successes. Also, don’t be too hard on yourself if you have a bad day.  Start in again tomorrow.
  4. Put yourself in charge – share your goals with family and friends, but you must take responsibility for your future.

Katie shared how she had a goal to do a half marathon and discussed how she made the resolution with a friend, they registered for a marathon, paid their money, then she got a calendar and followed a training plan, and they completed the ½ marathon together. 

Why we will succeed:

  1. Tell others, get support and join groups
  2. Set realistic and attainable goals
  3. Review goals frequently, be compassionate with ourselves, and stay motivated
  4. Make a schedule, to do lists and use calendars
  5. Make a plan with bite-sized chunks to achieve the full goal

Top 5 New Year’s Resolution for 2019:

  1. Diet or eat healthier (71%)
  2. Exercise more (65%)
  3. Lose weight (54%)
  4. Save more and spend less money (32%)
  5. Learn a new skill or hobby (26%)

Some resolutions bariatric surgery patients can set:

  • Get back on track
  • Meal plan/prep
  • Try one new recipe each week
  • Eat more organic food
  • Sign up for a 5K
  • Tray a new exercise class – yoga, Zumba, dance class, weight lifting
  • Maintain weight loss
  • Lose the “holiday weight gain”

Non-weight related resolutions:

  • Volunteer
  • Read a book a month
  • Declutter
  • Detoxify
  • Travel
  • Learn something new
  • Decrease screen time
  • Get more sleep
  • Drink less alcohol

Fork-Free Hobbies

After a long day at work, at school, in the car or {insert daily obligation here}, your energy reserves and brain power have been thoroughly zapped. You manage to squeeze in a quick workout, grab dinner, knock out some laundry and maybe answer a few emails—and then before you know it, you find yourself halfway through a bag of chips, a pint of ice-cream or maybe just a few too many crackers with hummus. You’re not quite sure how or why you started eating in the first place…after all, dinner was just an hour or two ago, and you’re certainly not hungry. It’s just that for the first time all day, you finally have some down time, your phone has stopped ringing, no one is clamoring for your attention, your mind is wandering aimlessly and the food is just right there. If this scenario sounds all too familiar, you’re not alone. Studies have shown that people are much more likely to crave food—particularly sugary and fatty snacks—when they’re bored. After observing participants who were intentionally subjected to periods of boredom, scientists found that the people chose to eat as a way to break the monotony, not necessarily to enjoy the taste or to satisfy any degree of hunger.

If boredom is eating up your goals, the best strategy is to occupy your mind and body with thoughts and activities that have nothing to do with food. (Note: This only applies when you’re not physically hungry—if your body is giving you clear cues that it’s time to fuel up, you shouldn’t deprive it of the sustenance it needs.) So, next time your belly is full and your calendar is empty, try some of these fork-free ways to fill up those idle hours. (Source) 

 

Online Hobbies:

  • Start a blog/vlog about something you are passionate about
  • Buy and Re-Sell clothes online 
    • With your rapid weight loss this could be a great way to clean out your closet and make a little extra money
    • Facebook Marketplace, Mercari, Poshmark, and Craigslist are just a few options
  • Listen to a new podcast
    • Try to find something that inspires you, makes you laugh, or makes you feel good
  • Join a support group
    • There are so many online support groups that are very welcoming and helpful
    • There are also many bariatric support groups – click here to join ours. 

Hobbies to Save Money:

  • Thrift Shopping
    • This is a great way to save money on clothes while you are losing weight, find hidden treasures, and create a unique wardrobe
  • Couponing
    • Who doesn’t love saving money on every day household products and groceries?
  • Budgeting
    • Make a monthly/weekly budget to lay out expenses and keep your finances in line
  • Clean out that storage room or closet you’ve been meaning to and have a garage sale

Hobbies for the Social Butterfly:

  • Start a club
    • Wine tasting club, book club, art club, movie club, board game club etc.
  • Start a bowling league
  • Go to a weekly trivia night
  • Check out your local farmers market
    • This is a perfect way to save money on fresh organic produce and find unique craft vendors
  • Go to a weekly bingo night

Self-Care Hobbies:

  • Have a DIY spa day at home
    • Give yourself a facial, pedicure or manicure – Fact: you can’t open a bag of chips when you have wet nails
  • Go get a massage
  • Soak up some vitamin D – this can be a walk outside on a sunny winter day or an hour at the pool
  • Tap into your spiritual side – This would mean praying, meditating or just connecting with nature, anything that can sooth your soul
  • Take a hot bath

Outdoor Hobbies:

  • Start a garden 
  • Go camping with friends or family
  • Take your dog on a walk
  • Hunting
  • Fishing
  • Ride your bike around the neighborhood
  • Go sledding with your kids/grand-kids
  • Try skiing/snowboarding

Hobbies to Get More Active:

  • Try yoga at home or join a yoga studio
    • This can decrease stress and anxiety, take tension off the body, and reduce inflammation and chronic pain
  • Find a low-intensity workout class that works with your lifestyle
    • Zumba, Pilates, hot yoga, water aerobics etc.
  • Go swimming
  • Sign up for a race
    • 5k, 10k, etc
  • Go for a hike
  • Challenge yourself with indoor rock climbing

Hobbies that Sharpen the Mind:

  • Start a jigsaw puzzle
  • Learn new playing card games
  • Listen to an audio book
    • This is great during long drives when you’d otherwise be tempted to snack
  • Learn how to draw or paint
  • Play board games with friends or family
    • You could start a weekly board game night
  • Learn a new language it’s never too late!

Hobbies for the Adventurer: 

  • Map out your next vacation
    • Have you always wanted to go on a cruise – whats holding you back?
  • Try canoeing or kayaking
    • peaceful way to connect with nature and be active

Organizational/Cleaning Hobbies:

  • Vacuum out your car
  • Plan next week’s meals
    • put today’s cravings to good use by applying them (in a healthy way) to your future menu
  • Write down or track everything you’ve eaten so far today
    • this will help you be aware of your daily nutrition and avoid snacking
  • Empty out your kitchen cabinets
    • This is a great way to start fresh
    • Pitch or donate what you haven’t used and organize what’s left
  • Clean out different areas of your house one room at a time
    • you will be surprised how satisfying this is
  • Rearrange some furniture to give your house a new feel/look
  • Pack a donation box
    • When cleaning out various rooms look for items you haven’t used in the past year and create a package to donate to your local shelter or thrift shop

Hobbies for the Creative Mind:

  • Start some DIY home projects
    • spice up a room with a coat of paint or some new decorations
  • Make your own:
    • jewelry, candles, soap, etc
  • Start scrap-booking
    • You could do vacation albums, albums for your kids, or even make albums for friends and family as gifts
    • You could also make a transformation album of yourself to track your progress
  • Take a studio art class
    • learn to paint, do pottery, draw, etc.
  • Take up knitting, sewing, quilting, or cross-stitching
  • Do craft projects with your kids

Hobbies for the Music Lover:

  • Learn to play a new instrument
  • Join a singing choir 
  • Collect music
    • Start a record collection
  • Go to concerts

Leadership Hobbies:

  • Become a coach
    • This a great way to coach a sport or activity you love while potentially earning some extra income
  • Become a tutor
  • Join a board or committee and make a difference
  • Become a mentor to a group or an individual that needs guidance

Miscellaneous Hobbies:

  • Rescue a dog
    • Dogs can help reduce stress and are a great way to get some additional exercise by taking them on a walk
  • Become a pool/billiards pro
  • Learn how to throw darts
  • Create a family tree
  • Visit local museums
  • Start a collection
    • Snow globs, coins, vintage bar ware, records, postage stamps, etc.

 

If you feel you are caught up in emotional eating and would benefit from therapeutic assistance to help identify the root causes for your eating behaviors, please feel free to contact The Bariatric Center of Kansas City at 913-677-6319 to schedule an appointment with Dr. Coker or Dr. Sabapathy to help guide you to healthier eating behaviors and practices! 

 

Sources: 

https://www.sparkpeople.com/blog/blog.asp?post=40_things_to_do_instead_of_eat_when_youre_bored

 

January 8th, 2019 – 5K Running/Walking Information

Barb and Kari, the physical therapists at the Bariatric Center of KC, shared that we will be hosting a walk/run 5K to celebrate our patients. It is currently scheduled to be held here at Prairie Star on May 5th 2019, and all are welcome to come walk or run as little or as much as you want.  It will not be timed, so you can walk/run as fast or as slow as you want!

It is always important to prepare for a “race” by focusing on a few things that can help prevent any injuries.  One of the first things is to make sure you have a good running shoe.  Whether you are walking or running or alternating between walking and running, you want to get a good “running shoe.”  When looking for one, you want to go somewhere that will measure the length and width of your foot.  We all need a shoe that will give you good support while allowing your foot the flexibility it needs to flatten out a little with each step. 

Because most of us have a lower arch (Kari mentioned doing a “wet test” to see if you have a low or high arch.  Wet your foot and then step onto some dry cement to see the footprint left.)  You need a shoe that can bend in the toe area, but doesn’t bend in the middle.  This will give your arch the support it needs, and still allow the flexibility your foot needs with each step.  You want a shoe where the top half of the sole is straighter.  With a high arch, you want a shoe that has a curved sole to allow for that flexibility. 

If you experience plantar fasciitis you are going to need a more stable shoe.  You can also look for a Dr. Scholl’s insert to put in your shoe. You don’t need expensive orthotics. For best fit, take out the current insole in the shoe and replace it with the insert for plantar fasciitis. 

A good running shoe will usually cost around $100.  To get the best price, go to good running store and have them do an assessment and fit.  Then you can go online and see if you can get a better deal on that specific shoe.  Just don’t make the mistake of buying a cheap shoe, as it can lead to injuries or pain in hips, knees or feet.  Shoes should be replaced after 500 miles, as the material they are made of isn’t meant to last forever.   

One of the biggest mistakes people make prior to going for a run is not warming up.  You want to increase the blood flow to your legs and muscles by doing 5 minutes of walking followed by a few “dynamic stretching exercises.”  These will increase your flexibility, coordination and decrease the tightness in your muscles reducing pain after the run.  It will also lead to faster recovery after a run.  Some of the exercises that Barb demonstrated were:

  • Lunge walks
    • walk with long strides and bend knees a little with each step
  • High knee marching steps
    • walk while lifting your thighs up high enough that they are parallel to the ground
  • Butt kicks
    • walk trying to kick up your leg to hit your buttock as you walk

Always end each activity period with “static stretching” of the back of the thigh (hamstrings), front of the thigh (quadriceps), and the calves. 

If your goal is to be a runner, start with a walk/run option. Jeff Galloway has a training site at www.jeffgalloway.com

He developed the walk/run option as he was trying to find a way to train for a marathon that would allow him to run long distances without injury.  He alternates walking with running, and you can start as slowly as you need.  You don’t want to run until it hurts.  You want to learn to stop running and start walking before you get to that point. It allows you the benefits of running while also giving you short bursts of recovery so you can keep going.  If you have been inactive for a long period of time, please meet with the physical therapists so they can help you get started.

 

Gift Ideas for a Bariatric Patient

 

With the holidays coming up, many of our patients have been asking for gift ideas that will be helpful in their bariatric journey. We have created a list of great present ideas that will provide support and assistance towards weight loss success. Many of these ideas came directly from our patients, who first hand, know what will be the most helpful!

 

 

  • Kitchen
    • Digital Kitchen Scale
    • Portable Food Scale
    • Portion Control Plate 
    • Tupperware for Meal Preps
    • Measuring Cups
    • Water Bottle (with ounces labeled on it)
    • Gastric Sleeve/ Gastric Bypass Cookbook
  • Nutrition/Health
    • Bariatric Vitamins/Supplements – https://www.bariatricjourney.com/shop/
    • Gift Card to GNC or Local Health Food Store
    • Vitamin Case/Organizer
    • Gym Membership
    • Bathroom Weight Scale
    • Workout Clothes
    • Protein Shakes
    • An Activity Tracker
      • Fit-bit/Apple Watch/Garmin/etc.
    • Workout equipment for home
      • Weights
      • Yoga Mat
      • Workout Videos/Program
  • Clothes/Comfort
    • Gift Card to buy new clothes
    • Leggings
    • Sweaters
    • Abdominal Binder
    • Fuzzy Socks
    • Slippers
    • Robe
    • Good Walking Shoes
    • Heated Blanket
    • Insulated Hat and Gloves
  • Give the Gift of Support
    • Attend the gym with your signification other/ friend/ family/ etc.
    • Make healthy food choices with your signification other/ friend/ family/ etc.
    • Support his/her choice to have surgery
    • Be patient with your signification other/ friend/ family/ etc.
    • Help out around the house more than usual during their healing process

 

Linda’s Journey To A Healthy, Happy Life

We would like to introduce you to Linda. Linda had Vertical Sleeve Gastrectomy Surgery with Dr. Hoehn in December of 2014. Her highest weight was 300 pounds and her current weight, as of December 2018, is 163 pounds. She has dropped 8 pants sizes! Linda has had an amazing journey towards success, health, and life overall. She is here to share her journey!  

“When I was asked to talk about my weight loss journey, I felt compelled to explain the good along with the bad. I want anyone who is reading this to understand that I’ve walked in your shoes my entire life! I feel your pain and I know the hurt; but along with these things comes a light at the end of the tunnel. And if your anything like I was, you are at the crossroad I was. I want you to know there is hope when you feel hopeless and defeated! I’m absolute proof! If anyone would have told me I would be a size 10 at almost fifty I’d called them a liar. Maybe by reading my story you can see what might feel impossible is actually possible!

In 2014, I was forced at the age of 45 to retire from police work. Being a police officer was my life and all I’ve known since I was twenty-two years old. The realization that I had topped the scale at a whopping 300 lbs was almost more than I could bear. My professional life was a complete wreck, no one took me seriously any longer, it seemed I had lost my credibility with every pound packed on. I guess in reality seeing an obese female police officer really isn’t very intimidating after all, right! Nevertheless, regardless of appearances, I was no longer safe. I physically wasn’t able to hold my own any longer much less protect another human life. My health was quickly deteriorating! My personal life and health were spiraling downward. I’d felt like I’d lost my identity as a human being.

Then the most bizarre thing happened as my physical stature increased, I actually became more and more invisible to people. Doors were no longer held open for me as a courtesy and people would walk right past me in line as if I wasn’t there. I became visible when our family went out to eat, I always felt paranoid about how much food I’d put on my plate, because I watched as people judged me. I also very visible at a Bar–Que. Their intentions, as innocent as they may have been, were noticed. I could see friends moving the plastic chairs aside to give me the larger sturdier chair. It started out gradually but I noticed! And when going to a place with a booth, I was always pushing the table away from me so I could fit inside the booth.

Finally, my only respite from life was my precious beloved horse “Dancer”. We could ride for hours and find peace from the world; find my Zen! The very last time I rode my precious Dancer was the day we came off the mountain into the campground, as we rode past several adults sitting by their camp fire one older gentleman loudly asked me the name of my horse, I replied “Dancer”, he responded to me that I should rename my horse to “Dozer” because he can move mountains; I never rode Dancer again. I felt awful! Being so heavy and subjecting him to my weight. That thought hadn’t occurred to me prior to that day. The reality of my mortality had set in. My sleep apnea was so bad I never knew from night to night if I would wake up the next day. My body ached in every single joint. I was perpetually exhausted. Simple everyday tasks were overwhelming. I was a spectator in my own life. Watching my kids play; my granddaughter play. I planned my outings around places to sit down or how much walking was involved. My husband took our kids to events alone. Either I simply couldn’t walk it or couldn’t fit on a ride. Sadly, that is all lost time with my family I’ll never be able to get back; memories that were stolen from me by obesity. I thought I had no options, that being obese was just my fate; the hand I was dealt. Every single diet I tried only left me gaining the weight back plus additional pounds.

Then, I found out about weight loss surgery years prior to actually getting serious about having it done. A friend had gastric bypass and had incredible success. But at that time, I had the mindset that it was the easy way out and the lazy persons way out. Blah Blah Blah! Finally, however once faced with my own mortality I couldn’t look my family in the face and give up without just trying ONE MORE TIME! I Googled weight loss surgery options; started reading options and about different surgeons and the odds of insurance covering the procedure. I just assumed my insurance wouldn’t cover the procedure. I signed up for the consultation at The Bariatric Center of Kansas City! My husband and I discussed the options and decided on the sleeve for me. Once I filled out the paperwork Dr. Hoehn’s staff took care of all the insurance issues. I simply followed their instructions. They literally walked me through a process that I thought was impossible; and they made it possible.

My surgery was December 12, 2014. I’m not going to lie to anyone, this was not easy, and if anyone tells you it is, they are lying. The surgery is exactly what they say it is- a tool! The surgery does not change
your behaviors or the way your brain works. What it does do however is offer you a better then fighting chance to make permanent changes. I think the key to my success has been I’ve followed the main rule and that is always always always PROTEIN FIRST! No matter what. Proteins fill you up fast and keep you full. Plus, another one of the best tools I have is my Fitness Pal app. It’s a life saver. Use it faithfully! And take lots and lots of progress pictures; they are awesome when you hit plateaus. And you will! Keep your course. I thought a few times “Ok this must be it; all the weight I’m going to loose.” But nope just keep your focus and you will get back on track. Stand your ground and watch your body kick into high gear again. Drink tons and tons of water. Let me repeat this! Drink TONS AND TONS OF WATER!! I’m saying this about water because I’ve spent a couple weeks in the hospital for dehydration. Every complication I’ve had with the surgery has been self-inflicted. I got lazy or decided I didn’t need to follow doctor’s orders. Don’t be me! Do what you’re told the first time. Like I said when I started this I was going to give you the good with the bad. Now, I want to tell you about life after Bariatric Surgery! 

The first day I noticed I could move without pain was about at my fifty-pound loss. I woke up and went to the bathroom tossed my jams off, got dressed headed down the stairs and I froze in my tracks midway down the stairs. I felt like I was missing something; like I’d left the oven on at home kind of feeling. And it occurred to me that I had just got out of bed and got dressed with no pain; I wasn’t short of breath. I felt good! It was as foreign to me as learning a new language. My first thought was ok this is a good day. And the next day and the next, every day I noticed something else I could do. I tied my shoes without catching my breath. I wasn’t dragging my feet when I walked anymore. And the list just goes on and on. You will have your own “First days of.” And you will feel like a million bucks. Every goal you reach and every day you are actually participating in your life and are no longer a spectator. My husband and I go on adventures all the time now. But now he’s the one who needs to catch up. I play with my grown kids and our precious granddaughter. Life is beyond anything I’d ever hoped for. I feel absolutely fantastic. Plus, I think I’m looking pretty darn spiffy for a fifty-year-old grandma! Vanity aside my health is fantastic. I have no medical issues to speak of. I have so much I want to tell everyone! I want everyone to feel as good as I do now. But most of all if I could just let everyone know one thing it is to never give up!

Just a little update on my career, well I no longer have the desire to be a patrol officer. But I did get a job as a contractor for the Department of Defense. Guess what folks? I had to take a Navy physical agility test to qualify. I ran against men younger then my kids and I kicked butt! Not bad for an old gal! : )”

Thank you so much for sharing Linda! We are happy for all of the success you have had and we love seeing your confident smile! 🙂 If you are considering or interested in weight loss surgery click this link to sign up for our free no obligation weight loss seminar.  

December 4th, 2018 – Medications After Bariatric Surgery

Whitney Venegoni is one of our Nurse Practitioners who serves as a Primary Care Provider as well. She sees patients before and after surgery, and does medication management for many of our patients after surgery. We have 2 Nurse Practitioners: Whitney works full time and Lori Reckrey, APRN, works part time in the office on the 3rd floor (Suite 305 in Building A).

Whitney talked about medications following surgery. She shared with us questions that most commonly come up about different types of medications.

• Extended Release or Slow Release: Whitney will often switch medications that end in XR or SR, as they are designed to be released slowly throughout the day. After surgery, they may not remain in the gut long enough to work that way, so she will often switch the medication to an immediate release medication given more frequently. If the drug is a heart medication, she will defer to a patient’s cardiologist and follow their recommendations.

• Diabetes medication is complicated. Because there are so many different types of medications for diabetes and they all work a little differently, she has to look at each patient and medication very individually.

  • Usually she will stop Metformin, Invokana, and Farzxiga after surgery.
  • She avoids using glipizide and glimepiride as they can lead to low blood sugars more often.
  • Some patients won’t be able to stop their medications immediately, but everyone goes home on a lower dose than before surgery.
  • If a patient is on insulin, she will usually stop all the short acting insulin and leave patients on a much lower dose of long acting insulin.
  • She tries to switch patients from insulin to an oral agent as soon as possible. It can take a few weeks of adjustments to make sure patients are either completely off medication or managed well on a lower dose.

• Some medications have the side effect of causing weight gain, and she stops those. She can switch patients to a medication with similar action that does not result in weight gain.

• Blood pressure medication is usually stopped if the patient is only taking 1 or 2 medications. If someone is currently on 4 or 5 medications for BP, she will usually eliminate 2 or 3, and then work on reducing the dosages as weight loss occurs. Some BP medications are called beta-blockers, and are used for heart rhythm problems. These may need to be continued.

• Diuretics (water pills) are usually stopped completely the first week, as they could cause dehydration. If swelling occurs in the legs and feet, she may add a lower dose back to help decrease the swelling, especially if it is related to heart failure.

• Cholesterol medications are almost always stopped right after surgery, and the body is given time to adjust to the surgery. Frequently they will no longer be needed after surgery.

• Medications that adjust moods are not usually changed as long as they are working well and don’t cause weight gain. Some antidepressants can cause weight gain, so she will work with patients to switch them to another drug with similar action that doesn’t cause weight gain. This may take some time to adjust.

• Medications for overactive bladder may cause dryness, and it is important for patients to make sure they are drinking enough fluids.

• What antibiotics can I take or not? Erythromycin is very hard on your stomach, so you should not take it. Cefalexin and Macrobid (Nitrofurantoin) should not be used as they don’t absorb well after surgery. Augmentin is fine and all antibiotics should be taken after eating and NOT on an empty stomach.

• I have trouble knowing when to take omeprazole. I am still on it for GERD: Try taking it 30 – 60 minutes before breakfast and dinner to see if that helps. If not, there are acid reducers that are stronger we can try.

• Are there any medications you can take if you are a couple of years out from surgery and have a little weight regain? Yes. There medications that can help with cravings, and some that can boost your metabolism. Whitney can prescribe medications based on the problem you are having.

Our next support group will be January 8 of 2019 at 5:30 pm. We will continue to have support groups twice a month. The 1st Tuesday of every month will be at 5:30. During odd number months, we will meet again on the 3rd Tuesday at 5:30. On even numbered months, we will have the second group on Saturdays at 10 am. Hope to see you there.

November 29th, 2019 – Gallstone and Kidney Stone Information

Dustin Huff is Dr. Hamilton’s Physician Assistant.  He assists Dr. Hamilton in surgery and also sees patients in the clinic before and after surgery.  

One of the side effects of having bariatric surgery can be gallstones.  The liver produces bile to help in breaking down fat and cholesterol.  It stores this bile in the gallbladder which can then release it when you eat.  The more fat you eat, the more bile you need to help break it down during digestion.   

Gallbladders can become a problem in 3 ways:

  • You can develop a gallstone, which is a hardened deposit of bile – this may or may not cause pain and nausea
  • You can develop sludge in your gallbladder, which is thickened bile, which makes it harder for the body to excrete when you need it, making your nauseated
  • Biliary dyskinesia is a condition where your gallbladder is no longer as flexible as it was and loses its ability to squeeze out the bile

If you develop any of these conditions, you may develop nausea and pain in the upper right side of your abdomen.  It usually occurs at the very end of a meal or about 10 – 15 minutes after a meal. 

If the surgeon suspects you are having trouble with your gallbladder, he will usually order an ultrasound of the gallbladder to look for stones or sludge.  If none are seen, he may order a heptatobiliary scan to see if the gallbladder is no longer able to squeeze out the bile.  About 5 % of patients who have bariatric surgery develop gall stones or gallbladder problems in the first 12 – 24 months after surgery.  This usually occurs during the most rapid weight loss phase after surgery as the body is breaking down fatty tissue.  This causes the liver to secrete a lot of extra cholesterol into the bile which can then cause gallstones.  To prevent gallstones, it is important to keep yourself hydrated, and avoid fatty, fried food.  This will cause less stress on the gallbladder as you are breaking down body fat. 

Kidney stones happen very rarely, and patients are usually seen by their Primary Care Provider or a Urologist for treatment.  Most stones are made up of calcium oxalate.  As your body is metabolizing fat, it excretes calcium along with it, so you are losing calcium during weight loss.  In order to make up for the lost calcium, your body will dissolve bone in order to get more calcium if you are not taking enough in.  This is why taking calcium citrate tablets is so important to our patients after surgery.  Your blood work may not show a low calcium when the body is leaching it out of the bones. The only way to truly know you are getting enough calcium is to get a bone density scan.  The nurse practitioners can order that for you.  It is a very quick and easy test to ensure your bones are strong.

Other questions:

I think I am dehydrated:  symptoms of dehydration are dizziness, nausea, and darkened urine.  If you think you are dehydrated, call the office.  We have an outpatient infusion clinic where we can give you some extra IV fluids to get you hydrated again.

Why am I having leg cramps:  It can be from dehydration, and or it can be from a deficiency in some vitamins or minerals.   You can try a small magnesium supplement daily to see if it helps.  If you have numbness or tinging in your feet, please call the office so we can check for vitamin B deficiency.

I feel constipated, what can I take:   Not getting enough fluids can cause constipation after bariatric surgery.  Make sure you are getting 64 ounces a day of water or clear fluids.  Pain medication also can slow down the bowels.  We recommend stirring a spoonful of Miralax into your fluids daily, or using a couple of tablespoons of milk of magnesia when this occurs.  If you are really constipated, you can use a Dulcolax or Glycerin suppository.  Please don’t take a strong laxative.  Supplementing your diet with flax seeds or magnesium can also help.   Do not take a fiber supplement until you are taking in 65 ounces of fluid every day consistently.    

A Bariatric Guide to Thanksgiving

Mashed Potatoes! Apple Crisp! Stuffing! Holiday food can either inspire excitement or anxiety – or both – depending on your mind-set. Carb heavy meals and sweet treats are the root of many holiday meals, office parties, and events over the upcoming months. No one wants to feel deprived during the happiest time of year, so we are here to offer some insight on how to make it through the holidays without binge-eating, stressing out, or getting off track!

First and foremost, as long as you stay within your post-op guidelines you can allow yourself to indulge in the “real thing” over thanksgiving within reason. One of our Registered Dietitians, Annie, says that “the thanksgiving meal itself is not the problem, it’s the leftovers from thanksgiving that we continue to eat for the next week that are the true problem. Don’t make it a week long feast, make it a one meal indulgence.” Her recommendation: send the leftovers home with family and friends so they are not in the house for temptation.

Another rule would be to start with smaller portions. Grab half of what you think you would eat and truly enjoy each and every bite you take. Eat slow and chew slow so your body can cue fullness and satiety. As always, start with your protein and non-starchy vegetables and then move on to the carbohydrates and dessert. Eating this way will allow you to fill up on your healthier leaner food items so you will only need a few bites of the remaining items to be satisfied. 

Finally, try to refocus the main objective of thanksgiving away from eating. Enjoy the company you are around and the family and friends you do not get to see often! Be thankful to be able to spend quality time with your loved ones! 

We have listed some bariatric friendly thanksgiving dishes approved by our dietitians below: 

Cauliflower Mashed Potatoes

Ingredients
  • 1 medium head of cauliflower, broken into florets
  • 3 cloves garlic, peeled
  • 1 tbsp unsweetened almond milk
  • 1/3 cup parmesan cheese, grated
  • 1/2 tsp sea salt
  • 1/4 tsp ground black pepper
Instructions
  1. Heat a large stock pot (with steamer attachment) over high heat until boiling.
  2. Add the cauliflower and garlic cloves to a steaming basket and place over boiling water. Cover and steam until cauliflower is soft when poked with a fork, about 6-8 minutes. (Tip: If you let the cauliflower cool down a bit after it’s done steaming, it’ll dry out a bit, which makes it much easier to get a good texture on the mash. It also lets you add other flavorful liquids to balance out the moisture content.)
  3. Add the steamed cauliflower and garlic to a food processor (or, if you’d prefer, mix in a large bowl with an immersion blender or a potato masher). Add the parmesan, salt, and pepper.
  4. Pulse the food processor until all contents are mostly smooth. You want some texture here, but not a lot. You may need to scrape the sides of the blender or to move around the cauliflower to make sure it all gets mashed. Use the almond milk, tbsp. by tbsp., as needed to bring the mixture together. Try not to use too much as this will cause the mixture to get soupy. You want to keep it as thick as possible (like mashed potatoes).
  5. Serve hot. Garnish with fresh chives or whatever you like on your mashed potatoes

Serves: 4 | Calories: 103 | Fat: 3g | Carbs: 13.9 | Protein: 7.5g |

 

Low Carb Stuffing

Ingredients

  • 4 tbsp. butter
  • 1 tbsp .minced garlic
  • 1 small onion, diced
  • 1 large carrot, peeled and chopped
  • 2 celery stalks, chopped
  • 1 medium head cauliflower, chopped
  • 1 cup mushrooms, chopped
  • 1/2 tsp. pink Himalayan salt
  • 1/2 tsp. black pepper
  • 1 tbsp. fresh sage, chopped
  • 2 tbsp. fresh rosemary, chopped
  • 1/4 cup fresh parsley, chopped
  • 1/2 cup chicken broth

Instructions

  1. In a large skillet over medium heat, melt butter. Add garlic and sauté until fragrant.
  2. To skillet, add onion, carrot and celery and sauté until soft, about 10 minutes.
  3. Add cauliflower, mushrooms, salt, and pepper and sauté until tender, breaking apart cauliflower florets as they soften, about 12 minutes.
  4. Add sage, rosemary and parsley and stir until well-combined.
  5. Pour in chicken broth, cover and cook until liquid is fully absorbed, about 13-15 minutes.

Serves: 6| Calories: 108 | Fat: 7.5g | Carbs: 8.1 | Protein: 2.8g |

 

Healthy Chicken Gravy

Ingredients

  • 12 cup finely chopped onion
  • 12 cup finely chopped fresh mushrooms
  • 2 tablespoons chopped fresh parsley
  • 2 cups reduced-sodium fat-free chicken broth, divided
  • 2 tablespoons cornstarch
  • 1 pinch pepper

Instructions

  1. In a saucepan, saute onion, mushrooms and parsley in ¼ cup broth until vegetables are tender.
  2. Combine cornstarch, pepper, and ½ cup of broth; stir until smooth.
  3. Add to pan with the remaining broth.
  4. Bring to a boil, stirring occasionally; boil for 2 minutes.

Serves: 6 | Calories: 17.2 | Fat: 0g | Carbs: 4g | Protein: 0.4g |

 

Healthy Green Bean Casserole

Ingredients

  • 6 slices bacon chopped
  • 1/4 cup diced onion
  • 1 clove garlic minced
  • 8 ounces cream cheese
  • 1/2 cup chicken broth
  • 1 tsp. salt
  • 1 tsp. ground pepper
  • 28 oz. frozen green beans
  • 1/2 cup crushed pork rinds
  • 1 tsp. dried onions

Instructions

  1. Preheat oven to 350 degrees.
  2. Add the bacon to a medium skillet over medium heat and cook, stirring frequently, until bacon is beginning to brown. 
  3. Add the onion and garlic to the bacon and continue cooking and stirring until bacon is crisp and onion is soft.
  4. Drain all but 1 tbsp. of grease from the skillet.
  5. Add the cream cheese and chicken broth to the skillet and cook over low heat, stirring constantly until the cream cheese has melted and the sauce is smooth and creamy. 
  6. Season with salt and pepper.
  7. Add the green beans to a 9×13 baking dish and sprinkle the top with the pork rinds and dried minced onion. 
  8. Bake for 30 minutes and serve immediately! 

Serves: 8 | Calories: 250 | Fat: 17g | Carbs: 5g | Protein: 15g |

 

Healthy Cranberry Sauce

Ingredients

  • 8 oz. fresh cranberries
  • 1 cup water
  • 2 tbsp. chia seeds
  • 40 drops liquid stevia

Instructions

  1. Heat a medium saucepan over medium heat and add the cranberries and water. Allow to reduce until you achieve consistency.
  2. The cranberries will burst and the should take about 8-10 minutes. 
  3. Once fully reduced and thickened to liking, remove from heat, and stir in the chia seeds and liquid stevia.
  4. Serve immediately. 

Serves: 8 | Calories: 30 | Fat: 0.75g | Carbs: 4.8g | Protein: 0.75g |

 

Keto Pumpkin Cheesecake Mousse

Ingredients

  • 12 ounces cream cheese, softened
  • 1 – 15 ounce can unsweetened pumpkin puree
  • 1/2 cup confectioners erythritol
  • 2 teaspoons pure vanilla extract
  • 2 tablespoons Pumpkin Pie Spice
  • 3/4 cup heavy cream

Instructions

  1. In a large mixing bowl, combine the cream cheese and pumpkin puree. Using a hand mixer, cream the two together until there are no visible clumps and the mixture is smooth and creamy.
  2. Add the erythritol, vanilla extract, pumpkin pie spice and heavy cream. Mix until all ingredients are will incorporated.
  3. Refrigerate for an hour before serving.

Serves: 10 | Calories: 215 | Fat: 18g | Carbs: 3g | Protein: 3g |

We hope you enjoy these recipes over Thanksgiving and, even more importantly, enjoy that special time with your friends and family. Happy Thanksgiving!

If you have any specific questions related to this information provided or would like to make an appointment with us, feel free to contact The Bariatric Center of Kansas City, 913-677-6319. Our specialists can assist you with information and bariatric support. 

If you’re interested in starting a bariatric journey soon, sign up to attend a free informational seminar today by registering at:  https://www.eventbrite.com/o/the-bariatric-center-of-kansas-city-at-shawnee-mission-health-lenexa-ks-324917613