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 | STEP
1
-- The first step in the surgical procedure makes your stomach smaller.
The surgeon divides the stomach into a small upper section and a larger
bottom section using staples that are similar to stitches. The top section
of the stomach (called the pouch) will hold your food. | STEP
2
-- After the stomach has been divided, the surgeon connects a section of
the small intestine to the pouch. When you eat, the food will now travel
from the pouch through this new connection ("Roux limb"),
bypassing the lower portion of the stomach. The surgeon will then
reconnect the base of the Roux limb with the remaining portion of the
small intestines from the bottom of the stomach, forming a y-shape. | |
CANDIDATES:
| A
Body
Mass Index (BMI) of 40 or more. BMI is a calculation based on height
and weight that is used to determine whether you are of normal weight or
are overweight. Someone with a BMI of 40 or more is at least 100 pounds
over their recommended weight. A normal BMI is between 18.5 and 25. | A
BMI of 35 or more along with a life-threatening illness that can be made
better with weight loss, such as sleep
apnea, type
2 diabetes, and heart
disease. | |
RISKS:
·
Bleeding
·
Infections
·
Follow-up
surgeries to correct complications, or to remove excess skin
·
Gallstones
due to significant weight loss in a short amount of time
·
Gastritis
(inflammation of the lining of the stomach)
·
Vomiting
from eating more than the stomach pouch can hold
·
Iron
or vitamin B12 deficiencies (if they occur) can lead to anemia
·
Calcium
deficiency (if it occurs) can contribute to the development of early
osteoporosis or other bone disorders
Gastric
bypass surgery was developed to induce weight loss and to avoid the medical
complications of severe obesity. The surgery greatly reduces the stomach to
the size of a small egg. A healthy diet after surgery helps with healing and
maintains nutritional health.
Making new food choices and developing new eating habits helps achieve
and maintain weight loss and prevent nutrition-related deficiencies or
complications such as anemia
and osteoporosis.
Key
Points to Follow after Surgery
1.
Put protein first at meals. After surgery, protein helps heal
wounds and helps reduce muscle loss. It is rich in important nutrients such as
zinc, iron, and magnesium.
Chew red meats thoroughly to avoid serious problems, such as stomach
obstruction or regurgitation.
2. Maintain a half-cup portion size at
meals for the first six months after surgery. Increase portions thereafter
to one cup. Frequent overeating at meals hinders weight loss and stretches the
stomach. So if you exceed the one-cup portion, consult a doctor or dietitian.
3. Avoid high-calorie drinks.
These include regular soda, pre-sweetened iced tea, alcohol, and fruit-juices.
Also
avoid carbonated beverages because they can cause excessive discomfort and
stretch the stomach.
5. Drink enough fluids. Consume at
least six cups or forty-eight ounces of fluid a day. Remember to sip slowly
and avoid gulping. A straw may
help slow down or control fluid intake.
For the first month after surgery:
Drink protein-rich fluid as much as possible. (Examples include: one percent
or skim milk, nutrient supplements such as Ensure® or No-Sugar-Added
Carnation)
6. Eat slowly and
stop eating and drinking when you are full. Pay attention to signs of
fullness to prevent overeating. Overeating or bingeing can stretch the stomach
and hinder weight loss.
7. Stick to sugar-free, low-fat foods.
Foods high in sugar and fat may cause diarrhea, abdominal discomfort or "dumping
syndrome." And they can slow weight loss.
Dumping syndrome results from a
rapid passage of food into the small intestine and shifts fluid too quickly
into the intestine. The result often is diarrhea and dehydration. Cramping,
sweating, flushed appearance, dizziness, weakness, and headache characterize
dumping syndrome.
Medications/Supplements: Many gastric bypass patients have other
disease states: diabetes, hypertension, hyperlipidemia. The patient needs to
continue medications after surgery. Medications should not be stopped until
advised by their surgeon or primary care physician. Patients may need to crush
tablets just after surgery in order to absorb medication. Therefore, sustained
release products are not recommended. Diuretics are also not recommended due
to chance of dehydration.
Vitamin supplementation should consist of a multivitamin, iron, B12, calcium, and possibly zinc, vitamin A, C, and E.
Sources:
Medline Plus, John Hopkins,
Did you know? If an FPA member recruits 10 new regular members they become
eligible for induction into the #1 Club. Membership includes free
registration
to next year's Annual meeting and Convention in
2005 marks the 20th anniversary of the #1 Club - and to increase its
visibility, we are sponsoring a Unit Association Membership Challenge.
The Challenge.....
The Unit Association who has the most inductees to the #1 Club at the 2005
convention wins an award!
The value of the free Convention registration (approximately $300) alone is
worth the effort of getting 10 unit members to join the FPA.
Professionally Yours,
Carmen Aceves-Blumenthal, B.S. Pharm, M.S., FASCP
Vice-Speaker,
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