Colorado Bariatric Surgery Institute

Bariatric surgery has proven to be a strong tool for those with diabetes. There is a high rate of resolution with the gastric bypass, as well as with the lap band. For those who are struggling with diabetes, considering bariatric surgery may be a good option. If it is not an option for you a new resource has been developed to help in the diabetic battle.

Food Science Corportaion announced the launch of a new full-service diabetes website, DiabetesCare.net, which can help those with diabetes by providing a resource for self-help and management. It provides the latest research and trends but also offers a helpful tool to engage visitors in managing thier diabetes. It has a nutrition tracker with over 37,000 food items, and exercise tracker, a blood glucose tracker and a BMI calculator. It also has recipes but most importantly it is free!

For information go to the website DiabetesCare.net

 

Sometimes we refer patients to outside mental health providers for additional support, or to work more intensively on problems which may impact their surgical success. Finding the right provider for you can take some time, but a good fit is well worth the effort.

Type of Providers
Psychiatrist: This is a medical doctor who can evaluate whether medication would be a helpful form of treatment and prescribe and monitor these medications if they are deemed appropriate. While some psychiatrists may provide psychotherapy, this has become the exception.

Psychotherapist: Often referred to as a “therapist” or “counselor”, this could be a clinical social worker, professional counselor, clinical psychologist, pastoral counselor or marriage and family therapist. A psychotherapist is trained to evaluate, diagnose and treat psychological, emotional and behavioral issues, using methods other than medication. This is accomplished through regular meetings where problems are discussed and solutions suggested. The psychotherapist’s role is to listen to the clients experiences as well as their goals, but also to act as a guide and coach, helping clients make necessary changes in their lives. Since there is a wide variety in the way different psychotherapist do their work, it is important to find somebody whose style you feel comfortable with.

It is important to note that there are specialists within these categories. It is essential to find a provider who is well versed in the areas you want help with.

Finding a Provider
There are several ways to identify the providers in your area.

Ask for a referral: Word of mouth can be a good way to identify a provider. Ask people you like and trust, such as a primary care physician, family member or friend, clergy etc. If your company has an EAP program, this can often be used anonymously to help you find a more long-term provider.

Find your local mental health center: Use the internet or phone book to find your local mental health center and call them to find out what services they offer.

Contact your insurance company: This is a good idea to find out what your coverage is. Most insurance companies will provide you with a list of mental health providers in your area. If there are multiple customer service numbers on your card, call the one for Mental Health/Substance Abuse”.


Search Online: many sites on the internet will give you information about providers in your area. Typically, the more elaborate sites will only show those providers who have paid to be listed. However, these sites often give summaries of provider styles and specialties. Some allow you to search by specialty, which can be helpful. One such site is http://therapists.psychologytoday.com.

Choosing a Provider
Finding a good match is essential for finding someone you can work well with. Because everybody is different and there is such variety in styles and techniques, provider are not a “one size fits all”. It is important to feel like your provider listens to you, works to understand what your goals are, respects you, and can offer you the help that you need.

It is a good idea to interview providers to find out a little about their area of expertise as well as how they work. You can sometimes do this when you call to make an appointment. In fact, some providers will offer a free over-the-phone consultation to determine whether they would be a good match for you. If you are unable to ask questions at this time (such as may be the case when making an appointment at a busy practice or mental health center) then feel free to ask questions at your first appointment. A good provider will welcome your questions and will be as eager as you are to make sure the two of you can work well together. Just because you have seen somebody once (or several times) does not mean you have to continue if it is not working. Finding a good provider is like dating: it can take several tries to find the best match.

Some questions you may want to ask include:
*Do you take my insurance?
*What do you charge?
*Do you work with a lot of people who are dealing with ______________?
*How do you work with people who ______________?
*How would you describe your style?
*What are your hours/availability?
*What is your cancellation policy?
*How would I contact you in an emergency?

Describe what you are looking for help with and what you think would help you the most. Now is not the time to worry about how you come across. The provider needs to get an honest look at what you need to be able to determine if he or she can be helpful to you.

Give the provider a realistic sense of your schedule and how flexible you can be. Remember, everybody wants evening appointments, and you may have to wait for availability. Willingness to be flexible, especially initially, can get you in with a good provider more quickly.

Labels: Counseling, Therapist

What does calcium do?
Calcium is very important for the health of your teeth and bones. 99% of the calcium in your body is stored in your teeth and bones. Calcium also helps the heart, brain, nerves, and muscles, and helps blood clot among other things.

What happens if my calcium is low/if I don’t get enough calcium?
Most people are not aware of how they feel when they don’t have enough calcium. Calcium is so important for keeping your heart beating and your brain going that when we don’t have enough in our diets, the body takes it from our bones. This is just like taking money out of the ATM without checking your account balance – you may not know until it is gone. For this reason, sometimes the very first symptom of calcium deficiency is an unexpected fracture or loss of a tooth.

If calcium deficiency is very severe or acute there can be muscle spasm or cramping, tingling, or burning sensation around the mouth and fingers, facial spasms and tics, seizures, and tremors.

The loss of calcium from bone is called osteopenia when it is mild and osteoporosis when it is severe. If calcium deficiency continues over a long time you can have permanent loss of bone that can result in fragility, broken bones, loss of mobility and more.

What are other symptoms?
Some other symptoms of calcium deficiency include:
Difficulty swallowing
Faintness
Anxiety, irritability
Low blood pressure
Intestinal cramping
Hip pain
Spinal pain
Compression fracture
Loss of height
Spasms of the lungs
Brittle nails and hair

Where can I get calcium?
The very best sources of calcium in food are dairy products such as milk, yogurt and cheese. There is also calcium in fortified soy and rice drinks, fortified juice, and fish where you eat the bones (like sardines). While some vegetables like leafy greens have calcium in them, this form of calcium is not well absorbed by people. Calcium is also found in dietary supplements as liquids, powders, tablets, capsules, and soft chews. If you do not get enough calcium in your diet or your calcium is low, your doctor will probably ask you to take calcium supplements as well as to watch calcium in your diet. If you have had weight loss surgery, it is recommended to take a specific form of calcium like calcium citrate which is better absorbed. Gastric bypass patients should take 1500 mg calcium citrate daily. Lap band and gastric sleeve patients should take 1200 mg calcium citrate daily. Remember to spread out your calcium through out the day. It is recommended to only take 500 mg at a time at least 2 hours apart for best absorption.

Other important things
Because you can’t usually feel calcium deficiency, many people do not know when they are not getting enough. Your doctor may ask you to have a bone density test to look at how much calcium you have in bone, or ask specific questions about your diet to learn how much calcium you typically eat. If you have low calcium or loss of bone, it is important that you follow up with your doctor for lab tests and other recommended care.

Happy New Year!

As we enter 2010, I thought it would be purposeful to look at 12 basic things we can use as signs of growth. In turn, as you are creating goals, trying to implement exercise regimens, dealing with cravings, and trying to plan out meals, remember these 12 notions; they might be helpful in your process!

A new year has begun and many people have made resolutions. Some of these may include eating healthier or starting an exercise program. For those who have had bariatric surgery these common resolutions should be a lifestyle.

For long term success it is important to continue following your nutrition and exercise recommendations. Your nutrition recommendations include:

• 60-80 grams of protein per day
• 64 ounces of non-caffeinated, non-carbonated, low-calorie fluids per day
• Following a low sugar, low fat, heart healthy nutrition program
• Take a multivitamin and calcium citrate daily, as well as iron and B50 complex for those who had the RNY procedure

Studies have shown that physical activity is the best predictor of long term weight loss maintenance. Your updated physical activity recommendations are:

According to the American College of Sports Medicine Position Stand, 2009 and the Physical Activity Guidelines for Americans, 2008, by the U.S. Department of Health and Human Services:

Healthy adults aged 18-65 years participate in:

Aerobic Activity:

• A minimum of 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or an equivalent combination of moderate and vigorous-intensity activity per week for health benefits. Aerobic activity should be performed in bouts of at least 10 minutes and should, preferably, be spread throughout the week on at least 3 occasions
  
• For additional health benefits adults should participate in 300 minutes of moderate-intensity activity or 150 minutes of vigorous-intensity activity or a combination of moderate and vigorous-intensity activity per week.
  
• For weight loss 150-250 minutes of moderate intensity activity per week provide modest weight loss. Greater than 250 minutes of moderate intensity activity per week may provide more significant weight loss.
  
• For weight maintenance after weight loss greater than 300 minutes of moderate intensity activity per week is recommended.
  

Muscular strength and endurance: A minimum of 8-10 exercises performed on two or more nonconsecutive days each week using the major muscle groups. Resistance should allow for 8-12 repetitions of each exercise.

Adults 65 years of age and over and adults aged 50-64 with chronic conditions or physical function limitations that affect mobility or physical fitness participate in:

• Aerobic activity: A minimum of 150 minutes of moderate intensity activity or 75 minutes of vigorous activity per week. Increase to 300 minutes per week as tolerated.
  
• Muscular strength and endurance (resistance training): A minimum of 8-10 exercises performed on two or more nonconsecutive days per week using the major muscle groups. Resistance should allow for 10-15 repetitions of each exercise.
  
• Balance exercises to reduce risk of falls.

The dietitians and social workers here at CBSI are here to help you stay on track, meet your goals, and enjoy long term success. Please contact us or make an appointment if you have any questions or concerns.

Yield 8 (3 oz servings)
21 g protein/serving

Ingredients:
Four 6-ounce fresh salmon filets
1 ½ tablespoons olive oil
4 tablespoons fresh orange juice
1 teaspoon salt
1 teaspoon onion powder
1 teaspoon paprika
½ teaspoon black pepper
1/8 teaspoon allspice
1/8 teaspoon cayenne pepper

Salsa
1 large avocado, diced
½ cup diced red onion
1 orange, diced
1 jalapeno pepper, seeded, ribs removed, and diced OR 1/8 teaspoon cayenne pepper
2 teaspoons fresh lime juice
3 tablespoons fresh orange juice
2 tablespoons fresh cilantro, minced
Kosher salt and black pepper to taste

Method:
1. In baking dish combine olive oil and orange juice. Lay salmon in mixture and turn to coat.
2. In a small bowl combine salt, onion powder, paprika, black pepper, allspice, and cayenne pepper. Sprinkle over each side of salmon filets. Set aside to marinate for 30 minutes.
3. In a small bowl combine the avocado, red onion, orange, jalapeno, and cilantro. Season with salt and pepper to taste. Cover and chill.
4. Heat large skillet over medium-high and lightly coat with vegetable cooking spray. Add salmon and cook for 4-5 minutes. Turn and cook on other side for 2-3 minutes or until fish flakes easily. Serve with chilled avocado salsa.

 

The holiday season is traditionally a difficult time for weight management. Between the cookies that lurk everywhere you turn and the increased social events and obligations which crowd out exercise, its easy to make the transition from overwhelmed to out of control.

This year can be different. With realistic expectations and planning, you can protect your hard work and enjoy the season's festivities. Use the following guide to formulate your personal Holiday Survival Plan. Write your answers down and revisit them often.
*************************************************************************************
Holiday Survival Plan

1. Holiday foods I want to indulge in (really like):

2. Holiday Foods I might be tempted to eat but agree to pass up:

3. Plan for physical activity:

4. Situations that may be challenging to me:
__Food in workplace
__Parties
__Edible gifts
__Family Gatherings
__Preparing food for others
__Eating while shopping
__Eating while traveling
__Emotional eating
__Making time for exercise
__Other_________________________

5. Three ways to protect myself from temptation in challenging situations:

6. People I can ask for support:

7. My reasons for working on lifestyle changes this holiday season:

Labels: holidays