Friday, November 19, 2010

A Heavy Load for a Little Boy




Kimberly Foley was seen by me in the office this week for her 1 year visit. She has had an amazing result! She has lost 97% of her excess weight. In fact she lost even more if you count her weight loss before her operation. She said she was willing to share her information with you.

5/21/09 Intake visit 384 lbs
11/9/09 Pre-op visit 356 lbs
11/18/10 1 yr Post-op 166 lbs

Her Body Mass Index dropped from 59 to 25.






Even more important, Kim shared a story that nearly brought tears to my eyes. Kim has a son Trevor who is 8 years old and a sister, Barbara, who is a funeral director.

One day Trevor said to Kim, “Mommy, I’m so proud of you for getting “thinny” so we don’t have to call Auntie Barb to get your funeral ready”.

Whew! What a heavy load this little one was carrying without anyone knowing it. You never know what kids are thinking.

How did Kim get such a great result? She said she had positive support from friends and family, she exercises 4 days a week and gave up elevators for lent!

Monday, November 15, 2010

Gastric Band and Autosnacking


"Autosnacking" is a word I invented to explain one of the reasons that patients who have a gastric band are not hungry for about 3 hours after eating. This term refers to the slow release of solid food from the gastric pouch as it passed through the area of narrowing created by the adjustable gastric band.

If the band is adjusted properly solid food will be held up by the band and allowed to reach the rest of the gastrointestinal track over the next couple of hours after eating. This suppresses the patients appetite just like snacking but without eating. after the food has passed the hormone, Ghrelin, will again begin to rise making the patient feel hungry about 3 hours after eating.

We use this time interval to determine whether someone needs a fill. If the patient is feeling hungry just an hour or so after eating a meal of solid food the band may need to be adjusted with more saline injected to make the band tighter and therefore narrowing the restriction slowing release of food from the pouch.

I emphasize solid food because the band is not designed to hold back liquids.

Other indicators for needing a fill include losing less than 1 pound a week and the ability to eat foods such as bread, chicken breast and / or steak.

Sunday, November 14, 2010

Update on Robotic Bariatric Surgery at Fresh Start


This is just a quick update on our robotic gastric bypass operations. We have now completed 23 Laparoscopic Roux en-Y Gastric Bypass operations with robotic assistance. We have had no complications from the robotic portion of the operation and the only complication was the infection from the non-robotic small intestinal connection that we reported in the previous update. The robotic portion has reduced in time from 2 hours to 45 minutes and most patients are now going home on the day after surgery. Overall I am delighted with our progress to date.