Weight Loss Surgery, Gastric Bypass
   
 
   
Bridges Weight Loss Center is a comprehensive surgical weight loss clinic offering Weight loss Surgery, Gastric bypass, Gastric banding, Lapband, Realize band, Sleeve Gastrectomy in Dallas, Austin, Houston, Texas USA

  1. What do I need to do to be successful after surgery?
  2. How often will I be seen after surgery?
  3. How often are your support groups?
  4. Do I meet with a nutritionist before and after surgery?
  5. What are the nutritional issues with weight loss surgery?
  6. Will I get a copy of suggested eating patterns and food choices after surgery?
  7. How much can I eat after my operation?
  8. What are the best choices of protein?
  9. How can I be sure I am eating enough protein?
  10. How long will I be restricted from eating solid foods after surgery?
  11. Will I be able to eat "spicy" foods or seasoned foods?
  12. Will I be allowed to drink alcohol?
  13. What vitamins will I need to take after surgery?
  14. Is it important to take calcium, iron, and trace elements?
  15. How much water should I be drinking after my surgery?
  16. Why do I need to drink so much fluid?
  17. Is there a problem with consuming milk products?
  18. Why can't I snack between meals?
  19. Is there any restriction of salt intake?
  20. Why can't I eat red meat after surgery?
  21. What's so important about exercise?
  22. What is the right amount of exercise after weight loss surgery?
  23. What is Dumping Syndrome?
  24. How can I know that I won't just keep losing weight until I waste away to nothing?
  25. Will I be miserably hungry after weight loss surgery since I'm not eating much?
  26. What if I am really hungry?
  27. What if I'm not hungry after surgery?
  28. Will I have excess skin?
  29. What can I do to prevent lots of excess skin?
  30. Will I have to change my medications?
  31. Is there any difficulty in taking medications?
  32. Will I lose hair after surgery? How can I prevent it?
  33. Can I get pregnant after weight loss surgery?
  34. Will I be able to take oral contraception after surgery?
  35. Is sexual activity restricted?
  1. What do I need to do to be successful after surgery?
    The basic rules are simple and easy to follow:
    1. During your hospitalization, the nursing staff will review with you your special dietary guidelines. You will need to follow these guidelines closely. Allowing time for proper healing of your new stomach pouch is necessary and important.
    2. When you are able to eat solids, eat 3 meals at a cup portion size per day, no more. Protein in the form of lean meats (chicken, turkey, and fish) and other low-fat sources should be eaten first. These should comprise at least half the volume of the meal eaten. Foods should be cooked without fat and seasoned to taste. Avoid sauces, gravies, butter, margarine, mayonnaise and junk foods.
    3. Never eat or snack between meals. Do not drink sugary, carbonated, caffeinated or alcoholic beverages. This includes diet soda.
    4. " Drink 48-64 oz or more of water each day. Water must be consumed slowly, 1 oz per 10 minutes, due to the restrictive effect of the operation. Liquids should be separated from solid meals by at least 30 minutes before and after.
    5. Take your vitamins daily as instructed prior to your operation.
    6. Exercise aerobically every day for at least 20-30 minutes (one-mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3-4 days per week, once you are 4 weeks out from your operation.
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  2. How often will I be seen after surgery?
    We pride ourselves on providing long term post-operative care for our patients. After your surgery, you will be seen at 2 weeks, 1 month, 3 months, 6 months, 12 months, 18 months, 24 months, and then on an annual basis for the first 5 years for gastric bypass and sleeve gastrectomy patients. Adjustable gastric banding patients are seen at 6-week intervals for the first 12 to 18 months after surgery in order to adjust the band. You may be seen more often if you are experiencing difficulties.
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  3. How often are your support groups?
    Support groups are held once a month. For now they are held on first the Thursday of the month. Please click on the "Seminar schedule" tab on the left of your screen to see the upcoming dates.
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  4. Do I meet with a nutritionist before and after surgery?
    Dr. Raja requires patients to consult with our nutrition and exercise counselor before surgery. Counseling after surgery takes place at each of your regularly scheduled visits.
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  5. What are the nutritional issues with weight loss surgery?
    Failure to follow the guidelines provided to you can lead to dietary consequences. If you do not consume 60-80 grams of protein per day this can lead to protein malnutrition. Failure to take your daily vitamin supplements can lead to various vitamin/mineral deficiencies.
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  6. Will I get a copy of suggested eating patterns and food choices after surgery?
    We will provide patients with materials that clearly outline the expectations regarding diet and compliance to guidelines for the best outcome based on your surgical procedure. After surgery, health and weight loss are highly dependent on patient compliance with these guidelines. You must do your part by restricting high-calorie foods, by avoiding sugar, snacks and fats, and by strictly following the guidelines set by Dr. Raja.
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  7. How much can I eat after my operation?
    Dr. Raja recommends eating 3 meals a day at a cup portion with an emphasis on protein.
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  8. What are the best choices of protein?
    Eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other seafood, chicken, and turkey are good sources of protein.
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  9. How can I be sure I am eating enough protein?
    60 to 80 grams of protein a day are the general recommendations.
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  10. How long will I be restricted from eating solid foods after surgery?
    Dr. Raja recommends a period of 2-4 eeks or more without solid foods after surgery. A liquid diet, followed by a pureed diet, then a soft food diet is recommended for a period of time until adequate healing has occurred. Our nutrition and exercise counselor will provide you with specific dietary guidelines for the best post-surgical outcome.
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  11. Will I be able to eat "spicy" foods or seasoned foods?
    Most patients are able to enjoy spices after they are on a regular diet.
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  12. Will I be allowed to drink alcohol?
    You will find that even small amounts of alcohol will affect you quickly after gastric bypass surgery. It is suggested that you drink no alcohol for the first 3 months after surgery. Thereafter you may have a glass of wine or a small cocktail occasionally.
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  13. What vitamins will I need to take after surgery?
    Yes, Dr. Raja recommends daily multivitamin supplements for the rest of your life. You may click on the Vitamins and Nutritional Supplement eStore button on the left to see Dr. Raja's recommendations.
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  14. Is it important to take calcium, iron, and trace elements?
    All gastric bypass patients require these supplements. We will do blood test for your body's reserves and make recommendations based on your own need.
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  15. How much water should I be drinking after my surgery?
    You should drink between 48-64oz of fluid each day.
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  16. Why do I need to drink so much fluid?
    When you are losing weight, there are many waste products to eliminate, mostly in the urine. Some of these substances tend to form crystals, which can cause kidney stones. A high water intake protects you and helps your body to rid itself of waste products efficiently, promoting better weight loss. Water also fills your stomach and helps to prolong and intensify your sense of satisfaction with food. If you feel a desire to eat between meals, it may be because you did not drink enough water in the hour before.
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  17. Is there a problem with consuming milk products?
    Milk contains sugar known as lactose, which is not well digested by many individuals. This sugar passes through undigested until bacteria in the lower bowel digest it, producing irritating byproducts as well as gas. Depending on an individuals tolerance, some people find even the smallest amount of milk can cause cramps, gas and diarrhea.
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  18. Why can't I snack between meals?
    Snacking, nibbling or grazing on foods, usually high-calorie and high-fat foods, can add hundreds of calories a day to your intake, defeating the restrictive effect of your operation. Snacking will slow down your weight loss and will lead to weight regain.
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  19. Is there any restriction of salt intake?
    No, your salt intake will be unchanged unless otherwise instructed by your primary care physician. Salt should always be consumed in moderation.
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  20. Why can't I eat red meat after surgery?
    Red meat can be eaten after surgery, but you will need to be very careful. Dr. Raja recommends that you avoid red meat for the first several months. Red meats contain large amounts of meat fibers that hold it together, preventing you from separating it into small parts when you chew. The gristle can plug the outlet of your stomach pouch and prevent anything from passing through, which becomes very uncomfortable.
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  21. What's so important about exercise?
    When you have a weight loss surgery procedure, you lose weight because the amount of food energy (calories) you are able to eat is much less than your body needs to function. It has to make up the difference by burning reserves or unused tissues. Your body will tend to burn any unused muscle and fat it has saved up. If you do not exercise daily your body will consume your unused muscle, and you will lose muscle mass and strength. Daily aerobic exercise for 20-30 minutes will communicate to your body that you want to use your muscles and force it to burn the fat instead.
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  22. What is the right amount of exercise after weight loss surgery?
    Many patients are hesitant about exercising after surgery, but exercise is an essential component of success after surgery. Exercise begins on the afternoon of surgery; the patient must be out of bed and walking. The goal is to walk further on the next day, and progressively further every day after that, including the first few weeks at home. Patients are often released from medical restrictions and encouraged to begin exercising about 2 weeks after surgery, limited only by the level of wound discomfort. The type of exercise is dictated by the patient's overall condition. Some patients who have severe knee problems may not walk well, but may be able to swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able. Dr. Raja feels that after weight loss surgery patients should exercise 20-30 minutes per day, 6 days per week.
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  23. What is Dumping Syndrome?
    Eating sugars or other foods containing many small particles when you have an empty stomach can cause dumping syndrome in patients who have had a gastric bypass. Your body handles these small particles by diluting them with water, which reduces blood volume and causes a shock-like state. Sugar may also induce insulin shock due to the altered physiology of your intestinal tract. The result is a very unpleasant feeling: you break out in a cold clammy sweat, turn pale, feel "butterflies" in your stomach, and have a pounding pulse. Cramps and diarrhea may follow. This state can last for 30-60 minutes and can be quite uncomfortable; you may have to lie down until it goes away. This syndrome can be avoided by not eating the foods that are high in sugar, especially on an empty stomach.
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  24. How can I know that I won't just keep losing weight until I waste away to nothing?
    Patients may begin to wonder about this early after the surgery when they are losing 15-20 pounds per month, or maybe when they've lost more than 100 pounds and they're still losing weight. Two things allow weight to stabilize. First, a patient's ongoing metabolic needs (calories burned) decrease as the body sheds excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following weight loss surgery. The stomach pouch and the attached small intestine learn to work together better, and there is some expansion in pouch size over a period of months. The bottom line is that, in the absence of a surgical complication, patients are very unlikely to lose weight to the point of malnutrition.
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  25. Will I be miserably hungry after weight loss surgery since I'm not eating much?
    Most patients say no. In fact, for the first 4-6 weeks patients have almost no appetite. Over the next several months the appetite returns, but it tends not to be a ravenous type of hunger.
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  26. What if I am really hungry?
    The types of food you may be consuming may cause excessive hunger. Meals high in starches such as rice, pasta, and potatoes can leave you feeling hungry soon after a meal. Well-balanced meals that contain high amounts of protein lead to a feeling a fullness that is maintained longer. Be sure not to drink liquid with food since liquid washes food out of the pouch.
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  27. What if I'm not hungry after surgery?
    It's common not to have an appetite for the first month or 2 after weight loss surgery. If you are able to consume liquids reasonably well, there is a level of confidence that your appetite will increase with time.
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  28. Will I have excess skin?
    Many people heavy enough to meet the criteria for weight loss surgery have stretched their skin beyond the point from which it can shrink back. Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery as it is often seen as an elective surgery. However, some do pay for certain types of surgery to remove excess skin when complications arise from these excess skin folds.
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  29. What can I do to prevent lots of excess skin?
    A regular exercise program is an essential part of the after surgery regiment. Good nutrition, good hydration and a regular exercise regiment will help with minimizing excess skin. Unfortunately, many patients may still be left with large flaps of loose skin. It is important to realize that excess skin does not contribute to poor health in the manner that excess fat does i.e. diabetes, high blood pressure, high cholesterol etc.
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  30. Will I have to change my medications?
    Dr. Raja will determine whether medications for blood pressure, diabetes, etc., can be stopped when the conditions for which they are taken improve or resolve after weight loss surgery. For meds that need to be continued, the vast majority can be taken, absorbed and work the same as before weight loss surgery. Usually no change in dose is required. Two classes of medications that should be used only in consultation with Dr. Raja are diuretics and NSAIDs, which include most over-the-counter pain medicines with exception of Tylenol. NSAIDs such as ibuprofen and naproxen may create ulcers in the small pouch or the attached bowel. Most diuretic medicines make the kidneys lose potassium. With the dramatically reduced intake experienced by most weight loss surgery patients, they are unable to take in enough potassium from food to compensate. When potassium levels get too low, it can lead to fatal heart problems.
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  31. Is there any difficulty in taking medications?
    Dr. Raja recommends that medications be taken in crushed, chewed or liquid form for first six months after surgery. After six months pills or capsules that are smaller than eraser on a #2 pencil may be taken whole. Pills larger than that size should be cut into that size.
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  32. Will I lose hair after surgery? How can I prevent it?
    Many patients experience some hair loss or thinning after surgery. This usually occurs between the 4th and the 8th month after surgery. Consistent intake of protein at mealtime is the most important prevention method. Also recommended are a daily B and zinc supplement and at least 48-64 oz of fluid intake. Most patients experience natural hair re-growth after the initial period of loss.
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  33. Can I get pregnant after weight loss surgery?
    It is strongly recommended that women wait about 2 years after weight loss surgery before a pregnancy. At this time, your body will be fairly stable, from a weight and nutrition standpoint, and you should be able to carry a healthy nourished fetus. You should notify your obstetrician of your prior weight loss surgery as you plan for pregnancy.
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  34. Will I be able to take oral contraception after surgery?
    Most patients have no difficulty in taking these pills. Dr. Raja recommends taking all medications in a crushed, chewable, or liquid form for the first 6 months after surgery.
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  35. Is sexual activity restricted?
    Patients can return to normal sexual intimacy when wound healing and discomfort permit. Many patients experience a drop in desire for about 2-4 weeks.
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