Smoking Following Weight Loss
recently received this email asking about the dangers of smoking
to our gastrointestinal systems
I had my
gastric bypass surgery in May 2010. I had three strictures in six
months which I had to have endoscopes to open up. Shortly
thereafter, I was having problems with holding food down; liquids
were never a problem. I lost at least 100 lbs. my first 8 to10
months because of all the problems I had keeping food down. I was
in and out of the ER at least three times my first year because of
severe pain where my stoma was. On one of the visits to the ER, I
had an MRI performed and found that I had a very large deep ulcer
at the stoma site.
winter, I had a revision due to that ulcer. The surgeon told me
that the ulcer attached itself to my liver and when cutting it out
he had to take part of my liver. He explained that was the reason
I was having so much discomfort and couldn't eat.
I am a
smoker, although I don't smoke heavily. Of course, they blamed my
smoking as the reason I had the ulcer in the first place.
I did well
for about six months then I started having problems again. I have
been seeing a gastroenterologist since December 2011. My doctor
used different medications to heal another large ulcer that had
again formed at the stoma site. Again, smoking was blamed.
In May 2012, the gastroenterologist did another endoscope and informed me
that I had the largest ulcer he has ever seen and he referred me
back to my surgeon.
I saw my
surgeon at the end of May, and was given an hour long lecture from
his nurse about my smoking; even though I had cut my smoking down
significantly. According to him, one cigarette was too much!
I will see
my surgeon again in the middle of July to discuss another
revision. He has given me some recommendations to follow and
wants to see if any of those help me. They haven't. I feel that I
will be facing another surgery in the coming month, because I have
started to lose more weight, the pain is still there, and I am
still pretty much only able to hold down liquids.
talked to many people over the course of two years that have had
gastric bypass surgery. Many of them continued to smoke after
their surgeries and have not developed any ulcers or problems that
I have. I am not convinced that the smoking is the culprit;
especially because I am not a heavy smoker.
I have days
when I wish I didn't have surgery, but then realize just how much
happier I am since I did. I only get sick when I eat and liquids
continue to be fine although I just want to eat so badly without
vomiting. I have almost become accustomed to that. I do wish at
times that I could eat some of my favorite foods such as Chinese,
hamburgers, pasta; but I have pretty much given up on that.
I just would
like to know whether you have had any complaints from people that
may be in the same situation as me? I would love to hear from you
on this subject because I haven't received any articles from you
pertaining to problems with smoking after gastric bypass surgery.
Sorry, but I am going to side with your doctors and nurse here.
Smoking is horrible when it comes to healing and in the formation
of ulcers. I do address that in my book, "Weight Loss Surgery;
Finding the Thin Person Hiding Inside You"
that you have talked with people who have smoked following weight
loss surgery who did not form ulcers, but that's not your
experience. Likewise, there are people who can eat horrible diets
very high in fat who will not have high cholesterol levels. But
with most people, a high fat diet will result in high cholesterol.
It is the same with smoking and ulcers. There are people who can
smoke after surgery and not suffer any ill effects. Most people
can't do that, and you are one of them. You seem to be
particularly susceptible to ulcers, and even one cigarette makes
your condition worse. You need to believe it!
I know how
difficult it is to stop smoking. I was an extremely heavy smoker.
This doesn't even seem possible now, but I smoked three packs of
cigarettes a day. I loved smoking.
though it has been 26 years, 8 months and 16 days (literally)
since I stopped smoking, I sometimes still miss it. It was only
the arrival of my daughter that got me to stop.
You need a
compelling reason to stop smoking and I would think that your body
can take only so many ulcers. You need to stop smoking and stop
Back on Track with Barbara
Internet Mentoring Program
The Back on Track with Barbara Internet
Mentoring Program really concentrates on lifestyle changes. Join our
group and receive lessons via the internet and the support of others who
are struggling just like you are.
suffering from emotional eating and can’t stop?
||Are you grazing
on carbohydrates and can’t control it?
||Are you lacking
inspiration to lose the weight you have regained?
||Do you feel that
you don’t know what to do now that you have had surgery?
||Are you dying to
be in better shape?
My Back on Track Internet Mentoring
Program is just what you
need to start your plan to get your weight under control.
and Listen to a
FREE Telephone Seminar
clicking here and scrolling down to the
bottom of the page.
My question regarding "Weight Loss Surgery -
the Worst Thing" prompted people to write to me about some very
interesting topics such as the one below.
My two "worst things" about WLS are kidney stones and vitamin D
I never had any problems with kidney stones
prior to my weight loss surgery in 2004. Since 2007, I have had 6
procedures to break up the kidney stones and one in which I had a
stint in place for 10 days. The pain of passing a kidney stone or
having one too big to pass is indescribable! It has been so intense
that two Vicodin will not touch the pain, and I've had to go to the
emergency room for a shot of morphine.
My stones are calcium oscillate and a test
showed that I am deficient in citrate. So I take a potassium
citrate supplement and have modified my diet accordingly, but I
still form stones. I consider this the absolute worst side effect
of weight loss surgery!!
I take 50,000 IU of Vitamin D twice a week in
order to maintain a low normal level in my body. One side effect of
taking so much vitamin D is that I have a high para thyroid hormone
reading but the para thyroid glands do not have any tumors on them.
A little background - I had my weight loss
surgery March 17, 2004. My starting weight was 373 (my all time high
was 400+), it took me over a year to lose 125 pounds and I currently
weigh around 250. I still need to lose at least another 60-70
pounds which would put me around 180. I had regained about 30
pounds, but was able to lose them last summer and have been able to
maintain my current weight for 10 months.
One of my biggest challenges has been my
allergy to artificial sweeteners. My reaction when I accidentally
ingest an artificial sweetener is anaphalixis. Needless to say, I
am a very big label reader. At the beginning, I had many episodes
of "dumping" until I found my tolerance level of sugar. Luckily
Stevia is becoming more widely used which has made life much
easier and I now have access to zero calorie beverages. Weight loss
though is still very difficult for me, and it always has been. I had
to fight for every pound lost.
Unfortunately, kidney stones is a side effect of weight loss
surgery, as you will read in the article I cite below. According to
the article published in the
June 2009 issue of the Journal of
weight loss surgery patients are almost twice as susceptible to
kidney stones as those who have not had surgery. The study goes on
to say that this is not a criticism of weight loss surgery because
of all the other benefits of the surgery.
For awhile, it was thought that the kidney
stones were from the excess calcium that we have to take, and
unfortunately some patients - even those directed by their doctors,
decreased their calcium intake. That was not a good recommendation,
and it made the situation worse. Kidney stones are often caused by
an excess of a dietary component known as oxalate, which normally
binds with calcium and is flushed out of the body. Because we do not
absorb calcium properly, we might not have enough calcium for the
oxalate to bind to. Therefore it is even more important to take
sufficient calcium - especially calcium citrate which gastric bypass
patients can absorb. You may also want to increase your water
I have never experienced kidney stones but I
can imagine they are bad enough to want to do anything to avoid
Inspiration to Lose Weight
Weekly Email Messages that Will Keep
You Motivated to Lose Weight and Stay Healthy
Staying in the proper frame of mind to
continue losing weight can be hard when life's challenges always
lead you astray. Weekly messages will keep you on a steady
track to lose weight.
weekly motivational messages today
to stay on track with your weight loss.
for more information
Here is a sample
Believe In Yourself
gone through life believing in the strength and
competence of others; never in my own. Now, dazzled, I
discovered that my capacities were real. It was like
finding a fortune in the lining of an old coat."
Dieting can really wreck havoc with
self-esteem. We lose weight, and then the pounds can
creep back on. We lose our self confidence. We
lose the ability to believe in ourselves and our
decisions. You can be
successful. Just remember that you
have more strength and resolve
than you give yourself credit for. Sometimes you
have to just trust in the strength that is in you.
Feta Salmon Salad
This is prime grilling season and here is a dish
that is packed with protein and nutrients. It is light and healthy, and
family will love it!
dried parsley flakes
4 salmon fillets (6 ounces
(5 ounces) spring mix salad greens
1 large cucumber, chopped
1 large tomato, chopped
crumbled feta cheese
red wine vinaigrette
Combine the seasonings; sprinkle over salmon.
Moisten a paper towel with cooking oil; using long-handled tongs,
lightly coat the grill rack. Place salmon skin side down on grill
Grill, covered, over medium heat or broil 4 in.
from the heat for 10-12 minutes or until fish flakes easily with a
In a large bowl, combine the salad greens,
cucumber, tomato and feta cheese; divide among four plates. Top with
salmon; drizzle with vinaigrette. Yield: 4 servings.
1 serving equals 416
calories, 25 g fat (6 g saturated fat), 108 mg cholesterol, 636 mg
sodium, 7 g carbohydrate, 2 g fiber, 38 g protein.
If you have a recipe that you would like to share in future issues of
this newsletter, please send it to me at
I want to offer a special thanks to Kristen Kotik.
Here is her story:
Thank you for giving me permission to feel successful, by
stating, “You had the courage to have weight loss surgery, so whatever
happens, and wherever you are in your journey, you are a success!” in
your April newsletter. I am 9.5 years post-op RNY, and enjoy the many
individual successes and endure the failures as I go through this WLS
I started at 309, 5’8.5”; with a goal of 180 lbs.
Within 11 months I was down to 145 and looked gaunt. The only view of
myself that I’ve ever understood, is "fat" and "not good enough." Losing
the weight hasn’t changed that for me – it’s magnified my skewed
I’ve always been an over-achiever and God has
blessed me with many talents. I have always found myself going over and
above for others - using my talents, because that’s what God wants me to
do! RIGHT? Unfortunately, I do this instead of taking care of myself;
almost as if it’s a way to make others "like" or "accept" me and not
just look at me as a "fat person."
My surgeon, support staff and group members were
fantastic in my early years post-op, and educated me well on the
necessities after surgery – but knowing and doing are different things.
About six years ago I moved from the Kansas City
area where my surgeon and support team was located, to a town of 20,000
in Northeast Nebraska. The nearest bariatric program is an hour and
forty-five minutes one-way. I consider myself relatively intelligent,
and had convinced myself that I could get my psyche worked out on my
own. Humph. I am now a full-blown bulimic and dealing with depression
that is more severe than ever before in my life. My negative self-talk
and incorrect self-image has won over again. That’s my failure. But, I’m
not going to let it be the end of my story (as I cry typing this and
still have feelings of doubt).
Ever since I moved to Nebraska, I wanted to start a
support group for WLS patients. I have always been in sales and
marketing, and last September I began a marketing position with a local
compounding pharmacy. I knew it was the right step for my professional
life, but I never dreamed what it would do for me personally.
Our pharmacy focuses on healthy lifestyles. What
better outlet to begin a WLS support group?! With permission from my
owner/pharmacist, I began researching online tools, contacting the area
WLS clinic coordinators in the surrounding areas, and reading reading,
reading. All the while, continuing to destroy my body with the bulimia
and negative thoughts.
I look the picture of health. My clothing
camouflages my post surgery sags, with the help of compression body
suits. Most would never guess that my now 155-165 lb. frame was once
309. As the marketing director, you are the public messenger and the
face – adding pressure to “do as I say, not as I do.” The guilt of
talking the talk of a healthy lifestyle and then going home to hide so
that I could binge and purge was taking its toll; mentally, physically,
and professionally. Now add the realization that the date for our first
WLS support group meeting is getting closer – and my hypocritical
actions broke me.
Nine day ago I hit bottom, knowing that I have to
stop this behavior for fear of hernia, tearing & leakage, etc, and all I
could think was, “BUT I DON’T WANT TO!” I knew that was ridiculous. I’m
a smart girl – why am I doing this? The self-talk has to change. I knew
then that I needed help.
One of the WLS coordinators had emailed several
patients in my area about the plans for a new support group. One of them
had emailed me and told me how excited she is, and how she would love to
help. I called her and have been better off ever since. We haven’t even
talked yet about our specific struggles, but we have both admitted to
having them. That was enough to make me WANT to change. Amazing how
contagious the human spirit can be. Am I cured? No, this is not
something that can be cured. I am open to getting professional help if I
cannot continue to treat myself well and talk to myself in a more
positive way. Right now, I am trying to remain "present" at all times,
with complete cognizant thought of what I am putting into my mouth, how
much and why. This has helped so far, and at the right time, I will
share this with those in our new support group.
Barbara, I read your book, “Weight Loss Surgery;
Finding the Thin Person Hiding Inside You” pre-op and I am now reading
it again. Thank you for aiding me to realize that my success is not a
before and after picture. Nor is WLS success a list of numbers from
where you’ve been to where you are now. Today, I learned that, “I had
the courage to have weight loss surgery, so whatever happens, and
wherever I am in my journey, I am a success”. This will now be the
mission statement for our new group. Thank you.
love good news. If you have good news, a success story to share, or
inspiration, please send it to me at
Barbara@wlscenter.com so that I can include it in future issues.
Coalition "Your Weight
October 25th to 28th the Obesity Action
Coalition is having their "Your Weight Matters" inaugural convention in Dallas, TX. If
you haven't yet registered, please go to
http://www.obesityaction.org/oac-annual-convention to find out
all about the convention and the incredible program that you don't
want to miss.
Something that is easily overlooked is the
free advocacy training for all those who are registered. It is
Thursday afternoon from noon to 5:00 PM.
If you have ever wanted to know what you can
do to help the OAC, then you want to be sure to register for the
training as well. On the online registration, you have to indicate
that you want to attend. Don't pass up this free opportunity!
Chew Your Vitamins
The OAC is the ONLY non
profit organization whose sole focus is helping those affected
by obesity. The OAC is a great place to turn if you are
looking for a way to get involved and give back to the cause of
There are a variety of ways
you can make a difference, but the first step is to become an
OAC Member. The great thing about OAC Membership is that
you can be as involved as you would like. Simply being a
member contributes to the cause of obesity.
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Barbara Thompson’s free newsletter featuring helpful information and
research material to help patients succeed following weight loss
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