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Bon Secours St. Mary’s Hospital Bariatric Surgery Patient’s Newsletter
Respect • Compassion • Justice • Integrity • Quality • Innovation • Stewardship • Growth
Summer 2015
Good Nutrition: Staying Hydrated: One Sip at a Time by Sara Rammer, RD
Staying hydrated is an important goal in the immediate days after surgery. It’s also important in the long term.
Dehydration occurs when your body does not have enough fluids to function properly. This can occur quickly, within a few days or less. Moreover, dehydration can lead to nausea making it difficult to tolerate meal replacement shakes, solid foods and vitamin/mineral supplements.
After surgery your risk of dehydration is increased for the following reasons: You may drink less since you cannot drink before, during, or after meals. Your stomach size has reduced to the equivalent of an egg, which reduces the volume tolerated in one sitting. You are consuming less fluid from food sources since portions are reduced.
The goal is to sip slowly on 48-64 ounces of clear liquids. These should be sugar free, calorie free, non-carbonated beverages. Additional fluid may be needed to recover from exercise or hot, humid weather. Lastly, limit caffeinated beverages which may increase the risk of dehydration. This goal may be difficult to achieve. On the following page we have provided some strategies to overcome common obstacles.
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See recipes on pages 3 and 4
Common Obstacles Strategies to Overcome Obstacles
Your personal and/or work sched-ule distracts from consuming liq-uids throughout the day.
Keep a large water bottle or thermos on hand as a visu-al reminder.
Set an alarm on a phone or watch.
Write a reminder note and post on work desk, home re-frigerator, etc.
Have a co-worker, friend or relative provide you with friendly reminders via phone calls, text messages or in person.
You take sips of liquids through the day, but you’re unsure how much was consumed.
Use a journal to record fluids consumed morning, after-noon and evening.
Utilize a water bottle or thermos with measurements Pause during the day to review your progress.
You have a preference towards sugar sweetened and/or car-bonated beverages, which are eliminated after surgery.
Add flavor with artificially flavored products (Crystal Light®, Mio®, store brand versions, etc).
Add lemon, lime, orange, strawberry, cucumber or mint to plain cold or hot water for a refreshing twist.
For a savory option, chose reduced sodium chicken,
beef or vegetable broths.
You have a decreased appetite and/or a change in taste, which can be common after surgery.
Try hot or cold beverages.
Freeze beverages in ice cube trays or purchase sugar free popsicles.
Experiment with savory options such as chicken, beef or vegetable broths.
You might even prefer plain water.
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Good Recipes: Healthy Recipes Provided by Sara Rammer, RD
Cool Cucumber Lemonade
Yield: 32 – 8 oz servings (2 gallons) 2 qt. or 8 servings, 1 cup each Ingredients: 2 gallons water 1 cup thinly sliced cucumbers 1 packet Crystal Light® Lemonade Flavor Drink Mix (Look for products that prepare 2 quarts per 1 packet.)
Directions:
Add water to drink mix in 2-gallon pitcher. Stir until mix is dissolved.
Cut cucumber slices in half; add to pitcher.
Serve over ice.
Recipe obtained from http://www.kraftrecipes.com/
Citrus Mint Julep Ingredients:
1 gallon boiling water 2 cups fresh mint leaves 2 packets Crystal Light® Lemonade Flavor Drink Mix (Look for those that prepare 2 quarts per 1 packet.)
Directions: Pour boiling water over mint leaves. Let stand at room temperature for 1 hour. Discard mint. Add 2 packets of Crystal Light® to mint water. Stir until dissolved. Serve over ice. Yield: 16- 8 ounce servings (1 gallon). Recipe obtained from http://www.kraftrecipes.com/
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Buffalo Chicken Dip: Ingredients:
2 cups shredded cooked chicken
1-8 oz. pkg. low fat or fat free cream cheese, softened
1/2 cup hot sauce of choice
1/4 cup low fat shredded cheese of your choice.
1/2 cup homemade ranch dressing or a packaged low fat ranch dressing:
¼ cup plain Greek yogurt + ¼ cup butter-milk
Pinch of garlic powder and onion powder
Recipe submitted by De’ Shonta Ward and modified by Sara Rammer, RD.
Crab Dip with Spinach Ingredients:
1-8 ounce package fat free cream cheese 1⁄2 cup plain Greek yogurt or fat free sour cream 2 Tablespoons fat-free mayonnaise 3⁄4 cup fat-free or low fat cheddar cheese 2 cloves garlic, grated 3⁄4 cup finely chopped spinach 1-15 ounce can crabmeat, drained and rinsed Directions: Mix all together and fold in crab last. Top with a little cheese and green onion. Bake 350 for 30 minutes. Recipe submitted by De’ Shonta Ward and modified by Sara Rammer, RD.
Directions:
Preheat oven to 350°F.
Combine all ingredients and spoon into shallow 1-quart baking dish.
Bake 20 minutes or until mixture is thoroughly heated; stir.
Garnish with chopped green onions if desired.
Serve with non-starchy vegetables.
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We interviewed a patient who had a gastric bypass 6 months ago. This is a brief summary of her story.
Why did you have bariatric surgery?
I continued to gain weight and nothing else had helped me lose weight. I felt miserable and I didn’t like the way I looked. I couldn’t do simple things like clean my house or get in and out of the bathtub. I couldn’t keep up with my grandchildren. My blood pressure was increasing and my joints hurt.
What barriers did you face as you were trying to decide about having bariatric surgery?
I was aware of the complication of surgery and realized that when having surgery there is always the chance of dying. I also didn’t want to lose my hair.
How did you prepare for bariatric surgery?
I was so frustrated with myself, I just decided to move forward. I knew nothing eIse had worked in the past. I discussed having bariatric surgery with my husband and son. I knew I needed my husband’s support. I prayed for the surgeon doing my surgery and prayed that all would go well.
List some benefits that you are already experiencing from having had your surgery.
I don’t have joint pain anymore. I recently went to the beach and I didn’t need help getting up off my beach towel. I am not as tired. I have more energy. I feel better about myself. I am doing things with my grandchildren that I could not have done before I had the surgery.
What have been the most difficult issues related to having had bariatric surgery?
I had a post op wound complication. Initially, I had trouble taking in enough protein and taking in enough liquids. It was hard just being at home during recovery. I needed to get back into my routine.
What advice would you give to someone considering bariatric surgery?
Be aware that initially it is hard to take in enough protein and fluids. Try to get back into your routine. Go to support group. Have your partner on board with you.
Concluding comments: I am glad I had bariatric surgery. I wish I had done it sooner. It has been easier than I thought. Do it for yourself.
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Good Insight: Interview with a Patient
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Watch for Red Flags:
Clip out this handy tip sheet and post it for
quick reference.
It is important for patients to be prepared if they develop symptoms after their surgery. Listed below are eight red flag warnings to help patients intervene early. But it is also important for patients to remember if they have concerns to contact their surgeon.
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Our Bariatric Surgeons at Bon Secours General Surgery at St. Mary’s Hospital: Dr. Eliseo Bautista, Dr. Brennan Carmody, Dr. Joseph Karch, & Dr. Nathan Lee (804) 893-8676
Our Nurse Practitioners & Physicians Assistants at Bon Secours General Surgery at St. Mary’s Hospital: Jeannine Moss, Maya Paige, Erin Brown, & Stacy Gittler (804) 893-8676
Our Registered Dietitians at St. Mary’s Hospital: Sara Rammer (804) 287-7037 or email them at [email protected]
I would like to share with you a Summer inspired prayer:
Under the warmth of the summer sun the world awakes and blossoms into every imaginable color. You created a garden for us to enjoy and within it planted the most magical of flower and trees… Your garden is perfect its colors harmonious, its scale immense. Thank you for the warmth of your love sustaining this world, your garden. Celtic Prayer
Your Support Team For Life Is just a phone call away...
Good Words - From the Desk of: Barbara Ferguson, RN, BS, BSN, MHA, NE-BC Director Clinical Management: Cardiac Services, Bariatric Service Line, Surgical Specific Populations
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Good Support: St. Mary’s Bariatric Surgery Patient Support Groups
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Find a Support Group Meeting at: http://richmond.bonsecours.com/news-and-
events-calendar-of-events.html
How is Bon Secours Bariatric Support Group different than online support groups?
While online groups are convenient, especially with advanced technology, many are not managed by a medical professional. As a result, inaccurate information may be promoted unintentionally. They can provide a source for peer support, which is positive. When participating in online groups, be cautious regarding information discussed, especially information pertaining to diet and supplements. Remember, you can easily contact our team via phone, email or MyChart for sound information. Support groups are not a replacement for a medical professional.
What if I already have an excellent support system from friends and/or relatives?
Congratulations, that is great news! There is no such thing as too much support. Attending the program’s support group will provide added benefits. Did you know you can bring family/friends to support group as well? This may help them better support you from day to day. Additionally, fellow patients can directly relate to the challenges faced by making lifestyle changes. It’s possible a relative has also received surgery, creating a great opportunity for everyone to attend!
Congratulations on your weight loss!
The journey to weight loss and better health has up’s and down’s.
Have you experienced a weight plateau?
Are you nervous about telling relatives about your surgery?
How should you say no to desserts brought in by co-workers?
Are you concerned about sticking to your diet during the holidays or summer travels?
Are you simply feeling overwhelmed by making the lifestyle changes?
These are just a few concerns patients share with each other at support groups.
Available research shows patients who attend support group frequently experience greater weight loss.
A study in 2008, showed patients with the greatest attendance lost 8% more weight by 1 year after surgery1. That is significant!
What happens at Support Group?
The group is led by medical professionals with experience in weight loss surgery. These individuals include Nurse Practitioners, Physicians, Registered Dietitians, Physician’s Assistants and Registered Nurses. Occasionally a guest speaker is also present. While medical professionals guide the discussion, you and fellow patients share strategies and tips to cope with challenges and stressors. The team ensures accurate information is discussed in a safe and welcoming environment.
Song Z, Reinhardt K, Buzdon M, Liao P (2008) Association between support group attendance and weight loss after roux-en-Y gastric bypass. Surg Obes Relat Dis 4(2): 100-3
July 9 – “Is Plastic Surgery for Me?” - Dr. Stephen Chen
July 16 – Making Healthy Choices During Summer Vaca-tions - Sara Rammer, Dietitian
August 13 - Exercise Progression – When, Where, Why, and How Long? - Dave Puhala, Fitness Specialist
August 20 - Complications After Bariatric Surgery and How to Avoid Them - Dr. Lee, Bariatric Surgeon
September 10 - Meal Planning the Quick and Easy Way - Sara Rammer, Dietitian
September 17 - Fact and Fiction of Nutrition Supple-ments - Sara Rammer, Dietitian
October 8 - Let’s Tell Our Story Connie Garrett, MSN, RN
October 15 - Consignment Shopping - Keri Collins, MSN, RN
Change for Life Bariatric Support Group
St. Mary’s Hospital, Education Center (1st floor) 6:00PM – 7:00PM
