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Post op

Incisional Pain After Gastric Bypass Surgery

29/03/2022 by DrCurry Leave a Comment

pain

Pain after surgery is expected, particularly with the gastric bypass. This is a bigger, more involved surgery than the sleeve! Setting realistic expectations after surgery is important–you should expect to have some pain after surgery. 

 

We always inject local anesthetic in each incision, however the effect of this is only temporary. This can make it seem like your pain is getting worse, but it’s actually just the numbing medicine wearing off.  

 

Most of the discomfort in the gastric bypass there is one incision on the far left side of your abdomen.  This will commonly cause complaints such as: sharp or intense pain, dull cramping pain, burning, tugging, and pulling sensations. These are sometimes worsened by movements, or certain positions and the pain is not always felt directly underneath this incision.   These types of symptoms are normal and expected after bypass surgery. 

 

This incision is necessary in order to safely complete the surgery. Because of the size and depth of this incision, a suture is placed through the deep muscle layers to help prevent a hernia. This suture is almost always the cause of the symptoms described above. This pain will commonly last for 3-6 weeks and perhaps longer in some situations. 

 

We always do our best to minimize the discomfort associated with this incision, but we cannot completely eliminate this pain all together. Patients will be prescribed a narcotic pain medication, a muscle relaxer, and a pill which helps with neuropathic (nerve) pain. In addition to the medications, we recommend using ice packs over the incisions, 20 minutes on and 20 minutes off several times per day. This will help with the inflammation. After 2-3 days you may get better relief with a heating pad as the pain becomes more muscular in nature. 

 

This same far left incision can also be prone to infection, as at the end of the procedure we pull a little piece of small intestine out through it.  This can sometimes contain bacteria which can lead to infection, despite the fact that we place it in a sterile pouch before pulling it out.  Some of the first signs of infection are: fever, swelling at the incision site, redness around the incision, or drainage at the incision )particularly yellow thick foul smelling drainage).  Occasionally a clear or pale-red drainage will be present–this does not necessarily mean there is an infection. If you have concerns with your incisions, please contact us to have your incisions evaluated by our staff! 

Go back to the post-op navigator

Filed Under: Education, Post op, Uncategorized

How To Achieve Success After Weight Loss Surgery-The Three “M’s”

25/03/2022 by DrCurry Leave a Comment

By Dr. Trace Curry

Patients always want to know what they need to do to be successful after weight loss surgery, it’s one of the most common questions I’m asked.  In my experience treating thousands of patients over the past 20 years, it all boils down to the three M’s:

  • Motivation
  • Menu
  • Movement

Motivation

I listed motivation first as it is the key.  If you are not motivated to lose weight and improve your health, even the most powerful weight loss procedure will not work in the long run.  Weight loss surgery can be life saving, by reducing or eliminating current or future medical issues such as diabetes, heart disease, high blood pressure, and high cholesterol.  You must have the motivation to make permanent lifestyle changes that include the changes listed below.  It’s worth the effort!

If you feel like you motivation is fading, even if you are 10 years out from surgery, reach out to us so that we can bring you in to meet with the team and formulate a plan to get you back on track.

Menu

Menu is the second item in the list because if you are not eating the right types of foods, you simply cannot move enough to burn off the excess calories.   First off, you need to “get the white out” of your diet!  White food refers to foods that are white in color, meaning that they have been processed and refined.  Things includes things like table sugar, flour, pasta, rice, bread, crackers, and cereal.  Secondly, eliminate liquid calories from your diet.  Everything you drink after surgery, with rare exception, should be zero (or very low) calorie.

Keep in touch with our expert registered dietitians for suggestions on healthy substitutions for these items in your diet.

Movement

It’s very difficult to be sedentary and maintain your weight loss in the long run.  These operations frequently have enough power to provide significant short-term weight loss without exercising at all.  However, once you reach your nadir (your lowest weight achieved after surgery) if you are not active AND exercising you will regain weight.  In some cases you could regain all your weight, especially if your motivation and menus are lacking.  No matter what your physical condition is, you must start somewhere!  Everyone’s definition of exercise is a little different, so just pick something you can do and build on it from there.  I highly recommend getting a good fitness tracker so that you can make sure you are reaching your move goals and modifying them as your health improves.  I’m partial to the Apple Watch as it does a good job not only to encourage you to exercise, but also not to be sitting for the rest of the day!

If your mobility is significantly limited, check out these low-impact exercise options for overweight patients.

overweight person exercising

If you keep the 3 M’s in mind, you will be successful in your weight loss journey.  The sky is the limit!

Other Posts From Dr. Curry

  • anatomy of gastric sleeve procedure

    New Study Finds Weight Loss Surgery Extends Lives

    by Dr. Trace Curry, Cincinnati, Ohio I remember when I did my first laparoscopic gastric bypass in 2003 at Wayne Hospital in Greenville, Ohio.  I was a general surgeon then, and I wanted to branch out and challenge myself with more advanced procedures.  Those were the very early days of laparoscopic weight loss surgery, and [...]
  • scale

    Office Follow-up Schedule After Weight Loss Surgery

    JourneyLite Physicians Post-Surgical Follow-Up Protocol   JourneyLite is committed to patient success. As a best practice, JourneyLite Physicians follows the Metabolic and Bariatric Surgery and Quality Improvement Program (MBSAQIP) follow up protocol, and exceeds the MBSAQIP standards to ensure the highest quality care and long-term success for our patients. First year follow up consists of [...]
  • scale

    Pre-op Weight Loss

    Pre-op weight loss can be essential to reducing the risk of bariatric surgery.  Therefore we set some goals for most patients at your initial consultation.  These goals are higher in patients with a higher body mass index. Below you can see our typical pre-op weight loss goals to see where you will likely fall.  However [...]
  • Transcarent, Inc home page screenshot

    JourneyLite and Transcarent, Inc Partner to Provide Lower Cost Weight Loss Surgery

    JourneyLite Surgery Center is pleased to announce that, effective October 1, 2022, we will be the regional provider for bariatric surgery services for Transcarent, Inc. Transcarent describes their organization as “a health care experience company that makes it easy to get the high-quality, affordable health and care that everyone deserves. Transcarent puts consumers back in [...]
  • weight loss medications

    Crushing Medications After Weight Loss Surgery-Should I or Shouldn’t I?

    As a rule we recommend against crushing medications after weight loss surgery.  There are some larger pills, however, that can be difficult to get down in the early days when there is still some swelling present.  There are many medications, however, that should NOT be crushed under any circumstances.  Generally speaking, these are extended release [...]

Gastric Sleeve

vertical sleeve gastrectomy

Gastric Bypass

gastric bypass anatomy

Filed Under: Education, Post op

Breaking A Plateau After Weight Loss Surgery

23/03/2022 by DrCurry Leave a Comment

scaleBreaking a Weight Loss Plateau

Weight loss is a journey, and with that journey will come many struggles! A common discussion we have with patients is overcoming a stall or “plateau” in weight loss. Below are some tips to help break out of a weight loss plateau.

  • First of all, consider how far you have come!
    • Before you hit your plateau, you were most likely experiencing successful weight loss for quite some time.
    • Remember your non-scale victories! This can include feeling better, having more energy, clothes fitting better, being able to do things you haven’t been able to in a while, and feeling more confident! Success is not always measured by the amount of weight that you lose!
  • Work with a dietitian to reassess caloric needs.
    • Based on the amount of weight you have lost so far, your calorie needs may have changed and will need to be adjusted. This can include changing the amounts of protein, carbohydrates, and fat in the diet as well, which all contribute to calories in the diet.
    • Sometimes the timing of your meals will need to be adjusted rather than the amount of calories.
    • Adding variety into your diet can help add different nutrients into your diet and ramp up weight loss.
    • If you aren’t tracking food already, get back into it to see if any extra calories are sneaking into your diet somewhere.  Ideally, use our Healthtrac app so that our team has access to your data!
  • Ramp up your workout routine.
    • Increasing the amount or intensity of your workouts could help you break out of a weight loss plateau because it can:
      • Help you burn more calories.
      • Make you feel better mentally and physically.
      • Bring more structure into your day.
  • Weight loss isn’t only related to what you eat. Consider if there are other factors in your life affecting your ability to lose weight.
    • Lack of sleep, excessive stress, and mental health issues can cause the body to produce more cortisol, which can tell the body to store more fat.
    • Seek medical advice if these things are affecting your life.

We hope these tips help you to explore the cause of a weight loss plateau and find ways to remedy it. Remember: You are NOT a failure for falling into a stall with weight loss, you are doing the best you can!

“When you feel like quitting, think about why you started” ~ Anonymous

Filed Under: Education, Post op Tagged With: plateau

Importance of Post-op Labs!

07/10/2021 by DrCurry Leave a Comment

With weight loss surgery it is important to follow the recommendations of your team and get your labs drawn promptly when ordered!  If you are receiving this message, we have not yet received your lab results.  If you have not gotten them drawn please do so as soon as possible!  If you had them drawn, we have not received the results, so it would be helpful if you could contact the lab and ask them to fax them to us at 513-559-1235.

If you have any questions, please email our medical assistants at ma@curryweightloss.com, or call our office at 513-559-1222.

Sincerely,

JourneyLite Physicians

Filed Under: Education, Post op Tagged With: labs

Potassium

28/07/2021 by DrCurry Leave a Comment

minerals

Potassium

Function:  Promotes growth, maintains water balance, and helps regulate muscular activity.

Deficiency: Rare

Toxicity: Rarely occurs, except in kidney failure

Recommended Daily intake of Potassium is:

MEN AND WOMEN AGE 19+ YEARS = 4.7 GM/D

FOOD SOURCES

AMOUNT

# of MG

VEGETABLES

Swiss chard, boiled 1 cup 961
Lima beans, cooked 1 cup 955
Yam, cubed, cooked 1 cup 911
Winter squash, baked, cubed 1 cup 896
Spinach, boiled 1 cup 839
Crimini mushrooms, raw 5 oz-wt 635
Beets, boiled 1 cup 519
Potato, baked, with skin 1 cup 510
Broccoli, steamed 1 cup 505
Brussel sprouts, coiled 1 cup 495
Collard greens, boiled 1 cup 494
Green peas, boiled 1 cup 434
Tomato, ripe 1 cup 400
Carrots, raw 1 cup 394
Green beans, boiled 1 cup 374
Fennel, raw, sliced 1 cup 360
Summer squash, cooked, slices 1 cup 346
Celery, raw 1 cup 344
Romaine lettuce 2 cups 325
Sweet potato, with skin 1 each 306
Kale, boiled 1 cup 296
Turnip greens, cooked 1 cup 292
Asparagus, boiled 1 cup 288
Mustard greens, boiled 1 cup 282
Onions, raw 1 cup 251
Eggplant, cooked, cubes 1 cup 246
Cauliflower, boiled 1 cup 176
Bell peppers, red, raw, slices 1 cup 163
Cabbage, shredded, boiled 1 cup 146

 

FOOD SOURCES

AMOUNT

# of MG

NUTS/SEEDS/BEANS

Soybeans, cooked 1 cup 886
Pinto beans, cooked 1 cup 800
Lentils, cooked 1 cup 730
Kidney beans, cooked 1 cup 713
Split peas, cooked 1 cup 710

 

FOOD SOURCES

AMOUNT

# of MG

FRUITS

Avocado, slices 1 cup 875
Papaya 1 each 781
Figs, fresh 8 oz-wt 526
Cantaloupe, cubes 1 cup 494
Banana 1 each 467
Prunes ¼ cup 317
Kiwifruit 1 each  252
Strawberries 1 cup 239
Oranges 1 each 237
Watermelon, diced 1 cup 176
Grapes 1 cup 176
Grapefruit ½ each 159
Plum 1 each 114
Apricots 1 each 104

 

FOOD SOURCES

AMOUNT

# of MG

MEATS

Halibut, baked/broiled 4 oz-wt 653
Tuna, yellowfin, baked/broiled 4 oz-wt 645
Snapper, baked/broiled 4 oz-wt 592
Cod, baked/broiled 4 oz-wt 586
Scallops, baked/broiled 4 oz-wt 444

 

FOOD SOURCES

AMOUNT

# of MG

DAIRY PRODUCTS

Yogurt, low fat 1 cup 573
Goat’s milk 1 cup 499
Cow’s milk, 2% 1 cup 377

 

Filed Under: Education, Vitamins/Minerals/Micronutrients Tagged With: minerals, vitamins

Calcium

28/07/2021 by DrCurry Leave a Comment

minerals

Calcium

Function:  Builds bone and teeth, needed for muscle contraction/relaxation, blood clotting, and normal heart rhythm.

Deficiency: Decreased growth, osteoporosis, and rickets.

Toxicity: Kidney stones and calcium deposits in soft tissues.

 

Recommended Daily intake of Calcium is:

MEN AND WOMEN:   AGE 19-50 = 1000 MG/D   –    AGE 51+ = 1200 MG/D

FOOD SOURCES

AMOUNT

# of MG

DAIRY PRODUCTS

Ricotta Cheese, part skim 1 cup 669
Yogurt, nonfat plain 1 cup 452
Yogurt, low-fat plain 1 cup 415
Yogurt, low-fat with fruit 1 cup 313
Skim Milk 1 cup 303
Low-Fat milk/1% milk 1 cup 296
Buttermilk 1 cup 285
Soy milk 1 cup 284
Whole Milk 1 cup 291
Swiss Cheese 1 ounce 272
Cottage Cheese 1 cup 226
Cheddar Cheese 1 ounce 205
Ice Cream 1 cup 200
American Cheese 1 ounce 174
Ice Cream, soft serve ½ cup 137
Yogurt, frozen/plain ½ cup 89

 

PROTEIN FOODS

AMOUNT

# of MG
Tofu, with calcium sulfate ½ cup 434
Salmon, broiled/baked 3 ½ ounces 354
Sardines, canned w/bones 3 ounces 324
Quiche Lorraine ½ cup 211
Mackerel, canned w/bones 3 ounces 205
Salmon, canned w/bones 3 ounces 203
Tofu, no calcium sulfate ½ cup 130
Perch, baked 3 ounces 117
Shrimp, canned 3 ounces 98
Almonds ¼ cup 94
Soybean ½ cup 88
Chickpeas, cooked 1 cup 80
White beans ½ cup 65
Brazil Nuts 4 medium 28
Caviar 1 teaspoon 28
Sesame Seeds 2 ounces 68

 

VEGETABLES

AMOUNT

# of MG
Turnip greens, cooked ½ cup 184
Mustard greens, cooked ½ cup 183
Chinese cabbage, cooked ½ cup 158
Collard greens, cooked ½ cup 152
Kale, cooked ½ cup 134
Broccoli, cooked ½ cup 88
Okra, frozen, cooked ½ cup 88

 

FRUITS

AMOUNT

# of MG
Figs, dried 5 each 134
Rhubarb 3/8 cup 78
Prunes 4 large 57
Orange 1 each 52

 

Filed Under: Education, Vitamins/Minerals/Micronutrients Tagged With: minerals, vitamins

Iron

28/07/2021 by DrCurry Leave a Comment

minerals

Iron

Function:  Carrier of oxygen and helps prevent anemia.

Deficiency: Anemia, fatigue, sore mouth/tongue, and weight loss.

Toxicity: Severe vomiting, diarrhea, abdominal pain

 

Recommended Daily intake of Iron is:

MEN AGE 19-70 = 8 MG/D

WOMEN:AGE 19-50 = 18 MG/D

AGE 50+ = 8 MG/D

 

FOOD SOURCES

AMOUNT

# of MG

DAIRY PRODUCTS

Eggs 2 each 2

PROTEIN FOODS

Clams, raw 3 ounces 12
Liver, beef 2 ounces 5
Sardines, canned 3 ounces 5
Beans, lima, dry/cooked ½ cup 3
Beef, variety 3 ounces 3
Pork, variety (not ham) 3 ounces 3
Turkey, variety 3 ounces 3
Dry beans, split peas ½ cup 2
Soybeans, boiled ½ cup 2
Black-eyed peas, boiled ½ cup 2
Chicken, variety (no skins) 3 ounces 1
Garbanzos beans, canned ½ cup 1
Peanut Butter 1 Tablespoon 1

 

BREADS/CEREALS

Bulgar flour 3 ounces 21
Wheat bran, crude 3 ounces 15
Bran flakes ¾ cup 8
Corn flakes, fortified ¾ cup 8
Cream of wheat ½ cup 8
Malt-o-meal ½ cup 8
All Bran 1/3 cup 5
Waffle 1 each 3
Corn tortilla 1 each 3
Corn meal, enriched 3 ounces 3
Bread, white 1 slice 2
Rice, white, enriched raw 1 cup 2
Rice, brown, cooked 1 cup 1
Oatmeal, cooked ¾ cup 1
Enriched bread 1 slice 1
Whole grain bread 1 slice 1

 

FOOD SOURCES

AMOUNT

# of MG

FRUITS

Peaches, dried 3 ounces 4
Prune juice ½ cup 2
Apricots 2 each 1
Prunes, dried 2 each 1

 

FOOD SOURCES

AMOUNT

# of MG

VEGETABLES

Spinach, boiled ½ cup 3
Potato, with skin 6 ½ ounces/1 medium 3
Avocado 1 medium 2
Leafy greens, raw 1 cup 2
Asparagus ¾ cup cooked 2
Leafy greens, raw ¾ cup 2

Filed Under: Education, Vitamins/Minerals/Micronutrients Tagged With: minerals, vitamins

Vitamin B9 (Folic Acid)

28/07/2021 by DrCurry Leave a Comment

vitamins

Vitamin B-9 (Folic Acid)

Function:  Part of blood cells, necessary for cell division, and important in increasing the number of blood cells.

Deficiency: The symptoms of Folic Acid deficiency include:  oral lesions, swollen tongue, and anemia

Toxicity: Large doses of Folic Acid may damage the kidneys and may mask a B-12 deficiency.

 

Recommended Daily intake of Folic Acid is:

MEN AND WOMEN AGE 14+ YEARS = 400 MCG/D

 

FOOD SOURCES

AMOUNT

# of MCG

VEGETABLES

Asparagus, boiled 1 cup 263
Spinach, boiled 1 cup 262
Collard greens, boiled 1 cup 177
Turnip greens, boiled 1 cup 171
Lima beans, boiled 1 cup 156
Romaine lettuce 2 cup 152
Beets, boiled 1 cup 136
Split peas, cooked 1 cup 127
Mustard greens, boiled 1 cup 103
Green peas, boiled 1 cup 101
Broccoli, steamed 1 cup 94
Brussel Sprouts, boiled 1 cup 94
Corn, yellow, cooked 1 cup 76
Winter squash, baked, cubed 1 cup 57
Green beans, boiled 1 cup 42
Summer squash, cooked, slices 1 cup 36
Kelp (sea vegetable) ¼ cup 36
Celery, raw 1 cup 34
Onions, raw 1 cup 30
Cabbage, shredded, boiled 1 cup 30
Tomato, ripe 1 cup 27
Fennel, raw, sliced 1 cup 24
Bell peppers, red, raw, slices 1 cup 20
Crimini mushrooms, raw 5 oz-wt 20
Kale, boiled 1 cup 17
Carrots, raw 1 cup 17
Swiss chard, boiled 1 cup 15
Eggplant, cooked, cubed 1 cup 14
Cucumbers, slices, with peel 1 cup 14
Leeks, boiled 1 cup 13

 

FOOD SOURCES

AMOUNT

# of MCG

MEATS

Calves liver, braised 4 oz-wt 861

 

FOOD SOURCES

AMOUNT

# of MG

NUTS/SEEDS/BEANS/LENTILS

Lentils 1 cup 358
Pinto beans, cooked 1 cup 294
Garbanzo beans, cooked 1 cup 256
Black beans, cooked 1 cup 256
Navy beans, cooked 1 cup 254
Kidney beans, cooked 1 cup 229
Peanuts, raw ¼ cup 88
Sunflower seeds, raw ¼ cup 82

 

FOOD SOURCES

AMOUNT

# of IU

FRUITS

Papaya 1 each 116
Avocado, slices 1 cup 90
Oranges 1 each 40
Raspberries 1 cup 32
Cantaloupe, cubes 1 cup 27
Strawberries 1 cup 25
Grapefruit ½ each 15

 

Filed Under: Education, Vitamins/Minerals/Micronutrients

Vitamin B6 (Pyridoxine)

28/07/2021 by DrCurry Leave a Comment

Vitamin B-6 (Pyridoxine)

Function:  Needed for protein metabolism, supports energy-producing systems in the body, and affects hormones.

Deficiency: The symptoms of Vitamin B-6 deficiency include:  seizures, dermatitis, and anemia.

Toxicity: Not toxic if given orally unless tremendous levels are given; toxic if injected.

Recommended Daily intake of Vitamin B-6 is:

MALES AGE 14-50 YEARS = 1.3 MG/D

MALES AGE 51+ YEARS = 1.7 MG/D

FEMALES 14-50 YEARS = 1.2 MG/D

FEMALES 51+ YEARS = 1.5 MG/D

 

FOOD SOURCES

AMOUNT

# of MG

MEATS

Tuna, yellowfin, baked/broiled 4 oz-wt 1.18
Chicken breast, roasted 4 oz-wt .64
Calf’s liver, braised 4 oz-wt .56
Turkey breast, roasted 4oz-wt .54
Salmon, baked/broiled 4 oz-wt .52
Snapper, baked/broiled 4 oz-wt .52
Cod, baked/broiled 4 oz-wt .52
Beef tenderloin, lean, broiled 4 oz-wt .49
Halibut, baked/broiled 4 oz-wt .45
Venison 4 oz-wt .43

 

FOOD SOURCES

AMOUNT

# of MG

FRUITS

Banana 1 each .68
Watermelon, diced 1 cup .52
Avocado, sliced 1 cup .41
Cantaloupe, cubed 1 cup .18

 

FOOD SOURCES

AMOUNT

# of MG

VEGETABLES

Spinach, boiled 1 cup .44
Potato, baked, with skin 1 each .42
Green peas, boiled 1 cup .35
Yam, cubed, cooked 1 cup .31
Brussel sprouts, boiled 1 cup .28
Turnip greens, cooked 1 cup .26
Sweet potato, baked, with skin 1 each .25
Onions, raw 1 cup .19
Carrots, raw 1 cup .18
Kale, boiled 1 cup .18

 

Filed Under: Education, Vitamins/Minerals/Micronutrients

Vitamin B3 (Niacin)

28/07/2021 by DrCurry Leave a Comment

Niacin (Vitamin B-3)

Function:  Needed to produce energy in the body, for healthy skin, nerves, and digestive tract.

Deficiency: Niacin deficiency is called Pellagra, common symptoms include:  loss of appetite, swollen tongue, irritability, insomnia, rash, headache, mental changes (anxiety, confusion, dementia).

Toxicity: May cause heartburn, peptic ulcer, flushing (esp in face and neck), and tingling sensation.

Recommended Daily intake of Niacin is:

MALES AGE 14+ YEARS = 16 MG/D

FEMALES 14+ YEARS = 14 MG/D

FOOD SOURCES

AMOUNT

# of MG

MEATS

Chicken breast, roasted 4 oz-wt 14
Tuna, yellowfin, baked/broiled 4 oz-wt 14
Salmon, baked/broiled 4oz-wt 11
Calf’s liver, braised 4 oz-wt 10
Halibut, baked/broiled 4 oz-wt 8
Lamb loin, roasted 4 oz-wt 8
Venison 4 oz-wt 8
Turkey breast, roasted 4 oz-wt 7
Beef tenderloin, lean, broiled 4 oz-wt 4
Shrimp, steamed/boiled 4 oz-wt 3
Cod, baked/broiled 4 oz-wt 3

 

FOOD SOURCES

AMOUNT

# of MG

VEGETABLES

Crimini mushrooms, raw 1 cup 5
Green peas, boiled 1 cup 3
Asparagus, boiled 1 cup 2
Winter squash, baked, cubes 1 cup 1.5
Tomato, ripe 1 cup 1
Carrots, raw 1 cup 1
Collard Greens, boiled 1 cup 1
Broccoli, steamed 1 cup 1

 

FOOD SOURCES

AMOUNT

# of MG

NUTS/SEEDS/BEANS

Peanuts, raw ¼ cup 4

 

FOOD SOURCES

AMOUNT

# of MG

FRUITS

Raspberries 1 cup 1

 

Filed Under: Education, Vitamins/Minerals/Micronutrients

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