Freequently asked questions on May 22, 2007 7:36 am
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Here is what I found at www.mayoclinic.com
Muscle weighs more than fat.
Truth: Muscle is more dense than fat, therefore taking up LESS room.
One pound of muscle weighs the same as one pound of fat. Just as one pound of feathers weighs the same as one pound of bricks. The difference is in the VOLUME. Fat will take up A LOT more space than muscle.
Here is some good information I found on plateaus/stalls, everyone goes though periods of stalls which are not plateaus. The body going through an ajustment period and is loosing inches. We have stalls throughout our weight loss journey, first one ususally is about 3 weeks out.
Signs and symptoms Dehydration:
: Here is what I found at
Mild to moderate dehydration is likely to cause:
- Dry, sticky mouth
- Sleepiness or tiredness — children are likely to be less active than usual
- Decreased urine output — fewer than six wet diapers a day for infants and eight hours or more without urination for older children and teens
- Few or no tears when crying
- Muscle weakness
- Dizziness or lightheadedness
Severe dehydration, a medical emergency, can cause:
- Extreme thirst
- Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
- Very dry mouth, skin and mucous membranes
- Lack of sweating
- Little or no urination — any urine that is produced will be dark yellow or amber
- Sunken eyes
- Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold
- In infants, sunken fontanels — the soft spots on the top of a baby's head
- Low blood pressure
- Rapid heartbeat
- In the most serious cases, delirium or unconsciousness
Unfortunately, thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults. A better barometer is the color of your urine: clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration.
When to seek medical advice
If you're an adult, call your doctor if:
- You're not able to keep liquids down for 24 hours.
- You've been vomiting for more than two days.
- You're vomiting blood.
- You're dehydrated. Signs of dehydration include excessive thirst, dry mouth, deep yellow urine or little or no urine, and severe weakness, dizziness or lightheadedness.
- You notice blood in your bowel movements.
- You have a fever above 101 F.
Here is some good information I found on plateaus, everyone goes though periods of stalls which are not plateaus. The body going through an ajustment period and is loosing inches. We have stalls throughout our weight loss journey, first one ususally is about 3 weeks out. www.weightwatchers.com/util/art/index_art.aspx?abnum=1&art_id=23561
· Article by: The Weight Watchers Research Dept
Plateaus are a common part of the weight-loss process. A plateau happens when the scale is at a standstill for several weeks—if weight stays the same for one or two weeks or the rate of weight slows but doesn't stop, it's not a true plateau. The progression from initial weight loss to hitting a plateau follows a typical pattern.
The Predictable Cycle of Weight Loss
During the first few weeks of losing weight, a rapid drop in pounds is normal. When calories from food are reduced, the body gets needed energy by releasing its stores of glycogen, a type of carbohydrate found in the muscles and liver. Glycogen holds onto water, so when glycogen is burned for energy, it also releases the water—about 4 grams of water for every gram of glycogen—resulting in substantial weight loss that's mostly water.
Once the body uses up its glycogen stores, it starts to burn fat for energy. Unlike glycogen, fat does not store much water and each gram of fat releases more than twice the amount of energy (i.e., calories) than a gram of glycogen. The result is that weight loss slows down substantially. At this point, the recommended rate of weight loss is no more than an average of 2 pounds per week. Losing weight faster than this is generally a sign that amounts of lean muscle mass, which like glycogen is largely water, are being broken down for energy.
As the body's glycogen stores are replenished by increased carbohydrate intake, there is a corresponding retention of water. During this time, weight stabilizes or may temporarily increase.
Why Weight Loss Plateaus Happen
By 6 months, a weight loss plateau is likely to occur.1 While plateaus are an almost inevitable response to losing weight, the physiological reasons for why they occur is not well understood.
One area of current research involves a possible link to reduced levels of leptin, a hormone produced by fat cells that is involved in the regulation of appetite. Research has shown that weight loss causes a marked decrease in serum leptin levels, which may, in turn, increase appetite.2 Based on evidence from an animal study, scientists have suggested that a reduction in leptin may contribute to a weight-loss plateau.3 However, more research on leptin's role in human weight regulation is needed before conclusions can be drawn.
Metabolic processes during weight loss may also impact plateaus. Losing weight can lower metabolism since a smaller body carries less lean muscle mass and burns fewer calories to move it around. Additionally, lower calorie consumption means it takes fewer calories to digest and absorb food. Taken together, a state of energy equilibrium could result, with weight remaining steady for a period of time.
How Do I Know If I Have Them?
If your symptoms suggest a gallstone-obstructed duct, your doctor might first examine your skin for jaundice, then feel your abdomen to check for tenderness. A blood test may reveal evidence of an obstruction.
Because other digestive problems, such as an infection of the duct, can produce symptoms similar to those of a gallstone attack, the doctor may also run other tests to determine if gallstones are in fact the culprit. The most common technique is an ultrasound examination. This quick, painless procedure uses high-frequency sound waves to create pictures of the gallbladder, bile duct, and their contents. CT scans are also sometimes done to look at the anatomy of your internal organs.
A more complicated test may be used if the doctor suspects that a gallstone is lodged in the bile duct. Commonly known by the acronym ERCP, this test allows the physician to look at the bile duct through a small flexible tube called an endoscope. The doctor sprays the back of the patient's throat with an anesthetic drug to prevent gagging, then passes the endoscope into the mouth, through the stomach, and into the area of the small intestine where the bile duct enters. Dye is injected through the tube and into the bile duct, then X-rays are taken. The procedure takes about an hour.
What Are the Treatments?
In most cases, treatment of gallstones is considered necessary only if they are symptomatic. Of the various conventional treatments that are available, surgical removal of the gallbladder is the most widely used. Some alternative treatments have also been found to be effective in alleviating the symptoms of troublesome gallstones.
When deciding what course of action to take for symptomatic gallstones, doctors usually choose from among three main treatment options: Watchful waiting, nonsurgical therapy, and surgical removal of the gallbladder.
Though a gallstone episode can be extremely painful or frightening, almost a third to half of all people who experience an attack never have a recurrence. In some cases, the stone dissolves or becomes dislodged and thereby resumes its "silence." Because the problem may solve itself without intervention, many doctors take a wait-and-see approach following the initial episode.
Even when the patient has had repeated gallstone episodes, the physician may postpone treatment or surgery because of other health concerns. If your surgery has been delayed, you should remain under a doctor's care and report any recurrences of gallstone symptoms immediately.
If you are unable or unwilling to go through surgery for a gallstone problem that requires treatment, your physician may recommend one of several noninvasive techniques. Note that though these methods may destroy symptom-causing gallstones, they can do nothing to prevent others from forming and recurrence is common.
Some gallstones can be dissolved through the use of a bile salt, although the procedure can be used only with stones formed from cholesterol and not from bile pigments. The drug ursodiol (Actigall) is taken as a tablet and the salt dissolves the stone by increasing the level of bile acids in the gallbladder. Depending on its size, the gallstone may take months or even years to go away and often people need to take this medication indefinitely.
Another nonsurgical technique, shock wave therapy, uses high-frequency sound waves to fragment the stones. Bile salt is administered afterward to dissolve the small pieces.
A method called contact dissolution can also be used to dissolve gallstones. The doctor inserts a catheter through the abdomen, then injects a special drug directly into the gallbladder. In many cases, the stone disappears within a few hours. Contact dissolution and shock wave therapy are still considered experimental.
Doctors can also attempt to remove gallstones during an ERCP. During the procedure a cutting instrument is inserted through the endoscope to attempt removal of the stone
Here are some things you might want to do before surgery:
get a comprehensive list from surgeon on the do and don't meds
get a list from nut/surgeon on what you diet is at the different stages
check with hospital to see what they provide you during you in hospital stay
shop for staples for the family and yourself after surgery
(you might want to make sure you have at least a few weeks worth so you don't
have to shop real soon after surgery)
some suggestions for different eating stage:
clear liquid stage: clear broth, clear juice, clear soup, sf jello, sf popsicles
full liquid stage: cream soups (strained), sf yogurt (strained), milk, soy milk, sf pudding, protein drinks
purer: anything that can be blended to baby food consistancy
soft foods: things easy to chew like soft cheeses and ground meats
full foods: foods cut up to about the size of a pencil eraser and chewed up finely
things to bring to the hospital:
loose clothing to go home in
pillow for the car ride (makes it more comfy)
flushable wet wipes
long handled tongs (to use with wipes to keep you clean after the bathroom)
through away camera for before and after pics
Dumping: Patients may develop loose stools and/or abdominal cramps shortly after eating certain types of foods. These symptoms can be avoided by not eating the offending foods. Diarrhea is uncommon after gastric restrictive surgery and can be successfully treated with medication. Dumping is occasionally associated with brief periods of light-headedness, sweating or heart palpitations due to low blood sugar. These symptoms can usually be reduced by drinking a sweet liquid like fruit juice.
Obstruction of the opening of the stoma: This rare complication occurs in less than 1 out of 100 gastric bypass patients and can occur when a piece of food becomes lodged in the stoma. When this happens, the piece of food is removed through a tube (endoscope) passed from the mouth into the stomach.
Vitamin and/or iron deficiency: This may occur in a mild form in as many as 40 percent of patients after gastric bypass. Iron and some vitamins, most notably Vitamin B-12, are primarily absorbed in the stomach and upper part of the small intestine which is bypassed. Both the vitamin and iron deficiencies are easily treated by either oral supplementation or injections. Women who are regularly menstruating will need additional iron supplements.
Vitamin and iron deficiencies are uncommon after stapled gastroplasty because, with this operation, the food passes through the stomach and small intestine in the normal way.
Low calcium and protein levels and deficiencies in fat soluble vitamins (A,D,E) are known to occur after distal gastric bypass. Gas, flatulence and diarrhea may be more prominent after distal gastric bypass.
HAIR LOSS: Hair loss may be a temporary problem for some patients within the first six to twelve months after the operation. This is largely due to vitamin deficiency. There is no specific remedy other than proper nutrition and multivitamin supplements.
Saralicous came across this document on the web. It's the American Society of Plastic Surgeons...it has codes to use for your documentation and for your procedures. Diagnosis CODES are good!!!
ASPS Recommended Insurance Coverage Criteria
for Third-Party Payers
http://www.plasticsurgery.org/medical_professionals/health_p olicy/loader.cfm?url=/commonspot/security/getfile.cfm&PageID =18091