About My Facebook WLS Private Group
I am so excited about my new Facebook group,
called WLS Private Group. It is categorized
as a CLOSED group by Facebook. This does not mean it is closed
to new members. It is definitely open for new members and I hope
you will join. A CLOSED group in Facebook means that only members of
the group can read posts and comments. That provides members with
the privacy that what they are discussing cannot be seen by anyone
outside of the group membership.
The discussions in my WLS Private Group have
really been great. Within the past day, the discussions have been
about exercise, what's on your grocery list, eating out in a small
town, and Greek yogart.
Here are some comments from members:
“I love this site! I sure wish this was around when I was a new
post-op! I think I would be close to 300+ pounds off instead of
working my way to 250 off. I am learning so much as well.”
“I thank you for having this group. I read
everything every day.” Lora
“Isn’t this group wonderful? I have learned
more here than in months of going to a normal support group.”
us. We would love to have you. Just click on the box above.
ASMBS Annual Meeting
This is an abbreviated edition of my newsletter.
I am in Orlando right now attending the Annual Meeting of the American
Society for Metabolic and Bariatric Surgery. This annual meeting is
probably being attended by your surgeon, and his or her staff
including the bariatric coordinator, nurses, dietician, perhaps the
psychologist. The annual meeting allows colleagues to meet and share
research and techniques as well as to improve techniques. There are
some social activities at night, and the opportunity to renew
friendships. I look forward to this every year.
As Chairman of the Board of the Obesity Action
Coalition, I am spending my time at our booth; talk with people about
the OAC, letting them know all that we do, and trying to get them to
It is an important time and I love it!
The Gastric Sleeve
I have had more and more questions from people who
are having the gastric sleeve. This is becoming a more common and
popular form of weight loss surgery.
In the gastric sleeve, about 85% of the stomach is
removed. What is left is a thin eight inch long sleeve that is sealed by
staples along its outer edge. I have always thought that the sleeve, or
the portion of the stomach that remains, looks like a small, slim
The intestines are not rerouted, they are left
intact. When the patient eats, they feel fuller sooner because the
remaining stomach is so small. Also the portion of the stomach that is removed
contains the tissue that releases the hormone ghrelin. Ghrelin is known
as the hunger hormone. This hormone works on the brain to signal hunger.
With a dramatic decrease in ghrelin, patients are not motivated to eat.
After food is eaten, it passes through the pyloric
valve, just as it normally would. The pyloric valve is between the
stomach and intestines, and determines when to stop digestion in the
stomach and let it pass into the small intestines. Because this is
not a malabsorption procedure, there is little problem with nutritional
As with other weight loss surgery procedures,
patients see improvements in diabetes, high blood pressure, high
cholesterol and sleep apnea within one to two years.
With the gastric sleeve, patients lose
approximately 60% to 70% of their excess weight, so it is not quite as
successful as the gastric bypass, but nearly so.
is wonderful that there are more and more options for weight loss
surgery, so that patients are able to choose the type of surgery, and
later the lifestyle that suits them. With choices, patients can
ultimately be more successful.
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.
for Summertime Fun
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 will give you the
support you need to get your weight under control.
and Listen to a
FREE Telephone Seminar
clicking here and scrolling down to the
bottom of the page.
Absorption of Pain Medication
I am a gastric bypass patient, eight years post-op. I have a question
about pain medication. I will soon be having major back surgery. I
know we don't absorb food as well as we used to, so I assume that goes
for medications as well. I am wondering what to do about post-op pain
management. How much should I take in order to keep the major pain at
a decent level?
So many doctors are still not very familiar with
gastric bypass surgery, so it's hard to make them understand that we
may need more medication or a different plan than patients with a
normal stomach. Any tips or suggestions?
I don’t know of any studies that specifically pertain to pain
medications, but I do know of the following two studies that deal with
the absorption of anti-depressants and anti-psychotic medications.
Both studies show that gastric bypass post-op patients do not absorb
medications as well as they did prior to surgery. It is important that
your doctor understands this, and agrees to work with you on finding a
level of pain relief that is designed for you.
Here are the two studies:
A study was conducted by Dr. Giselle Hamad in
which she tested the blood of a woman who was taking an SSRI
(serotonin reuptake inhibitor) anti-depressant called sertraline. The
woman was tested before and after the surgery. In the study, her blood
was tested before taking her morning dose of her anti-depressant and
then every 30 minutes for the next eight hours. Here are the results:
Before surgery, the blood level of her
17.5 ng/ml before taking the medication
41.6 ng/ml at the peak level after taking the medication
After surgery, the blood level of her
11.1 ng/ml before taking the medication
14.4 ng/ml at the peak level after taking the medication
Naturally, after surgery when her anti-depressant
was not being absorbed, the patient complained of moodiness and
irritability. Many surgeons have attributed post-op depression to
problems of patients adjusting to surgery, or finding that their
circumstances have not improved significantly with their loss of
weight. However, the problem may be that patients are not
absorbing their medications.
Further study needs to be done, but this may
explain not only the depression of patients, but it may contribute to
weight regain, as post-op patients are unable to cope without the
absorption of their anti-depressant and turn to food to calm and
Frangou, Christine. SSRI Absorption Plummets after Gastric Bypass:
Case Study. General Surgery News, Vol. 35:09, Sept. 2008.
Here is another article that I have reported on
Seaman, Jeff S. et al. Dissolution of Common
Psychiatric Medications in a Roux-en-Y Gastric Bypass Model.
Psychosomatics. 46: 250-253, Je 2005.
In the article, the authors compare the absorption
of many psychiatric medications in pre-op patients and post-op
patients. While each medication shows less absorption in post-ops than
pre-ops, what is especially interesting is that each medication shows
a different level of absorption. Some medications are absorbed
better than others. Therefore there can be no general rule as to how
much of any one medication is absorbed.
Further, we are all different. Our surgeries may
be the same type, but our anatomies are all slightly different. Your
pouch and the exact amount of intestines bypassed vary depending upon your surgeon, your own anatomy, and even when your
surgery was performed because surgeons have been making pouches
smaller and smaller over the years. Because the variances are so
great, doctors or pharmacists cannot say that for every bypass patient
taking every medication, there will be a certain amount less
medication absorbed. The percentages can be all over the map.
Dosage should be adjusted for the best result
with the least amount of dosage. It is all very individual.
Best wishes on you upcoming back surgery.
Painful Story: Lisa S.
I want to offer a special thanks to Lisa S.
for sharing her story of pain with us. After reading her story, my
assessment (although I am not a medical professional of any kind) is
that she has a leak from her pouch into her old stomach. This is very
painful, and I have heard this from others who have had the same pain.
Here is her story:
I had gastric bypass surgery over 5 years ago and transformed from a
size 24/28 to a size 6/8 today. I went from a shocking 280 pounds
down to less than 130, and am currently at 155.
Although I was very pleased with the results from my bypass surgery, I
have been back and forth to doctors for over 2 years now dealing with
the same issues.
Let me start from the beginning. After I took off my excess weight, I
decided to have a tummy tuck and a breast lift and augmentation, which
took place about 3 years ago. The results were amazing!! But, about
a year later, I started to develop serious stomach pains that usually
took place right after eating.
Now I know that I am not perfect, and sometimes I eat things that
cause dumping, but this pain was different, and would happen after
eating anything, healthy or not.
For almost 2 years I was seen in Urgent Care regularly with the same
stomach issues (pain, cramping, bloating) so unbearable to handle that
it landed me there, because the pain was "urgent.” I saw and spoke to
my bypass surgeon and my primary care doctor about the pain, but they
just masked it with pain killers.
Then, this past January I again returned to Urgent Care, and the doctor
ordered a CT scan. It was then that he discovered that I had a
strangulated hernia that was causing part of my small intestine to die
off, and I was rushed to emergency surgery that same evening. I felt
so relieved to finally find the root of all my discomfort.
But, after weeks of recovery things still weren't right. I was still
feeling pain in my stomach, the same pain that brought me to the
hospital in the first place. Many tests were ordered; gall bladder
scans, blood tests, endoscopy, urine tests, etc., but the doctor found
nothing wrong with me.
I suppose that is good news, but my quality of life is completely
ruined. I have two beautiful teenage children and a husband that are
tired of me being ill all the time. I am not able to participate in
anything because of the pain that I am in. I don't know where to turn
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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