Starting October 28th 2019 our Prattville Support Group meetings will be held at St. Mark’s Episcopal Church. The address is

178 E. 4th St. Prattville Al. It will still be from 6-7pm. Please make note of

this change!!!

VOLUME 20 OCTOBER 2019

NUMBER 10

Editorial Notice

Editorial Staff:

Melissa Grant

Bariatric Coordinator

Bariatric Coordinator.

Items for the newsletter must be submitted by the 1

st of the month

for consideration for publication in the upcoming issue!

submit items to: melissa@morasurgicalclinic.com

If you no longer wish to

Receive Bariatric Bulletin, contact:

melissa@morasurgicalclinic.com

This newsletter is published

monthly for Dr. Parham Mora 645 McQueen Smith Road.

Suite 205 Prattville, Alabama 36066

Gastric bypass diet: What to eat after the surgery

Wondering what your diet will be like after your surgery? Learn which foods will help you heal and lose

weight safely.

By Mayo Clinic Staff

Overview

A gastric bypass diet helps people who are recovering from sleeve gastrectomy and from gastric bypass surgery —

also known as Roux-en-Y gastric bypass — to heal and to change their eating habits.

Your doctor or a registered dietitian will talk with you about the diet you'll need to follow after surgery, explaining what

types of food and how much you can eat at each meal. Closely following your gastric bypass diet can help you lose

weight safely.

Purpose

The gastric bypass diet is designed to:

Allow your stomach to heal without being stretched by the food you eat

Get you used to eating the smaller amounts of food that your smaller stomach can comfortably and safely digest

Help you lose weight and avoid gaining weight

Avoid side effects and complications from the surgery

Diet details

Diet recommendations after gastric bypass surgery vary depending on your individual situation.

A gastric bypass diet typically follows a staged approach to help you ease back into eating solid foods. How quickly

you move from one step to the next depends on how fast your body heals and adjusts to the change in eating

patterns. You can usually start eating regular foods about three months after surgery.

At each stage of the gastric bypass diet, you must be careful to:

Drink 64 ounces of fluid a day, to avoid dehydration.

Sip liquids between meals, not with meals. Wait about 30 minutes after a meal to drink anything and avoid drinking 30 minutes before a meal.

Eat and drink slowly, to avoid dumping syndrome — which occurs when foods and liquids enter your small intestine rapidly and in larger amounts than normal, causing nausea, vomiting, dizziness, sweating and diarrhea.

Eat lean, protein-rich foods daily.

Choose foods and drinks that are low in fats and sugar.

Avoid alcohol.

Limit caffeine, which can cause dehydration.

Take vitamin and mineral supplements daily as directed by your health provider.

Chew foods thoroughly to a pureed consistency before swallowing, once you progress beyond liquids only.

Liquids

For the first day or so after surgery, you'll only be allowed to drink clear liquids. Once you're handling clear liquids,

you can start having other liquids, such as:

Broth

Unsweetened juice

Decaffeinated tea or coffee

Milk (skim or 1 percent)

Sugar-free gelatin or popsicles

Pureed foods

After about a week of tolerating liquids, you can begin to eat strained and pureed (mashed up) foods. The foods

should have the consistency of a smooth paste or a thick liquid, without any solid pieces of food in the mixture.

You can eat three to six small meals a day. Each meal should consist of 4 to 6 tablespoons of food. Eat slowly —

about 30 minutes for each meal.

Choose foods that will puree well, such as:

Lean ground meat, poultry or fish

Cottage cheese

Soft scrambled eggs

Cooked cereal

Soft fruits and cooked vegetables

Strained cream soups Blend solid foods with a liquid, such as:

Water

Skim milk

Juice with no sugar added

Broth

Soft foods

After a few weeks of pureed foods, and with your doctor's OK, you can add soft foods to your diet. They should be

small, tender and easily chewed pieces of food.

You can eat three to five small meals a day. Each meal should consist of one-third to one-half cup of food. Chew

each bite until the food is pureed consistency before swallowing.

Soft foods include:

Ground lean meat or poultry

Flaked fish

Eggs

Cottage cheese

Cooked or dried cereal

Rice

Cooked vegetables, without skin

Solid foods

After about eight weeks on the gastric bypass diet, you can gradually return to eating firmer foods. Start with eating

three meals a day, with each meal consisting of 1 to 1-1/2 cups of food. It's important to stop eating before you feel

completely full.

Depending on how you tolerate solid food, you may be able to vary the number of meals and amount of food at each

meal. Talk to your dietitian about what's best for you.

Try new foods one at a time. Certain foods may cause pain, nausea or vomiting after gastric bypass surgery.

Foods that can cause problems at this stage include:

Breads

Carbonated drinks

Raw vegetables

Cooked fibrous vegetables, such as celery, broccoli, corn or cabbage

Tough meats or meats with gristle

Red meat

Fried foods

Highly seasoned or spicy foods

Nuts and seeds

Popcorn Over time, you might be able to try some of these foods again, with the guidance of your doctor.

A new healthy diet

Gastric bypass surgery reduces the size of your stomach and changes the way food enters your intestines. After

surgery, it's important to get adequate nourishment while keeping your weight-loss goals on track. Your doctor is

likely to recommend that you:

Eat and drink slowly. To avoid dumping syndrome, take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Wait 30 minutes before or after each meal to drink liquids.

Drink liquids between meals. To avoid dehydration, you'll need to drink at least 8 cups (1.9 liters) of fluids a day. But drinking too much liquid at or around mealtime can leave you feeling overly full and prevent you from eating enough nutrient-rich food.

Chew food thoroughly. The new opening that leads from your stomach into your small intestine is very narrow and can be blocked by larger pieces of food. Blockages prevent food from leaving your stomach and can cause vomiting, nausea and abdominal pain. Take small bites of food and chew them to a pureed consistency before swallowing.

Focus on high-protein foods. Eat these foods before you eat other foods in your meal.

Avoid foods that are high in fat and sugar. These foods travel quickly through your digestive system and cause dumping syndrome.

Take recommended vitamin and mineral supplements. After surgery your body won't be able to absorb enough nutrients from your food. You'll likely need to take a multivitamin supplement every day for the rest of your life.

Results

The gastric bypass diet can help you recover from surgery and transition to a way of eating that is healthy and

supports your weight-loss goals. Remember that if you return to unhealthy eating habits after weight-loss surgery,

you may not lose all of your excess weight, or you may regain any weight that you do lose.

Risks

The greatest risks of the gastric bypass diet come from not following the diet properly. If you eat too much or eat food

that you shouldn't, you could have complications. These include:

Dumping syndrome. If too much food enters your small intestine quickly, you are likely to experience nausea, vomiting, dizziness, sweating and diarrhea. Eating too much or too fast, eating foods high in fat or sugar, and not chewing your food adequately can all cause nausea or vomiting after meals.

Dehydration. Because you're not supposed to drink fluids with your meals, some people become dehydrated. That's why you need to sip 64 ounces (1.9 liters) of water and other fluids throughout the day.

Constipation. A lack of physical activity and of fiber or fluid in your diet can cause constipation.

Blocked opening of your stomach pouch. Food can become lodged at the opening of your stomach pouch, even if you carefully follow the diet. Signs and symptoms of a blocked stomach opening include ongoing nausea, vomiting and abdominal pain. Call your doctor if you have these symptoms for more than two days.

Weight gain or failure to lose weight. If you continue to gain weight or fail to lose weight on the gastric bypass diet, talk to your doctor or dietitian.

https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/gastric-bypass-diet/art-20048472

8 Great Apps to Get After You’ve Had Weight Loss Surgery

August 29, 2017 - by Ami Soma - in Weight Loss Surgery

Whether you’re considering weight loss surgery or have already

embarked on this life-changing journey, you’re in good company.

According to the American Society for Metabolic and Bariatric

Surgery, the number of people getting weight loss surgery has

increased by 24 percent in recent years, going from 158,000 in 2011

to 196,000 in 2015. As the community continues to grow, support is

just a smartphone away — with apps aimed at keeping you on track to

reach your goals every step of the way. Here are eight of our

favorites.

1. Get food smart

After weight loss surgery, you start looking at food in an entirely different way. Fooducate empowers you with nutritional

knowledge to help you make better decisions. More than just a meal tracker, the app works by assigning a letter grade (based on

nutritional value) to each food item. Every time you make a new meal entry, you’ll see a full ingredient breakdown, so you can

get the most bang for your bite.

2. For the journey

Specifically tailored for the weight loss journey, Baritastic provides pocket-sized support for all your pre- and post-surgery

needs. Unlike basic nutrition tracking apps, this handy tracker understands the unique needs of weight loss surgery patients. With

features like their “seminar to surgery checklist,” the app helps you stay on track get approved for surgery. After surgery, use the

app to set up daily reminders for water, protein shakes, vitamins and supplements.

3. Drink up

Proper hydration is especially important in the healing months following weight loss surgery, as it is extra hard to retain enough

fluid, according to the American Society for Metabolic and Bariatric Surgery. The Waterlogged app (for iOS and Android)

turns drinking water into a competitive sport against yourself. Simply select the amount of water you’ve had to drink and watch

your virtual water bottle fill up until you reach your hydration goal. Too busy to keep track of water intake? The app also lets you

set reminders so you can drink your way to better health.

4. Healthy buddy

With MyFitnessPal, on-the-go food tracking is simple. The app provides

users with access to the world’s largest nutrition and calorie database

featuring over 5 million foods. As one of the top-rated calorie-counting

apps, you’ll find a community of like-minded individuals to help you

along your journey. Plus, the app also features an extensive resource

library, so you can learn more about nutrition and reach your goals. The

app also measures your calorie output as you exercise, giving you accurate

calorie count based on your activity levels.

5. Positive thinking

Bariatric surgery is about more than just weight loss – it’s a total mind, body and soul journey. When times get tough, turn to the

power of positive thinking. A positive attitude improves outcomes and life satisfaction across a spectrum of conditions, Johns

Hopkins Medicine reports. The ThinkUp app helps by providing daily affirmations and motivation. It lets you create your own

self-improvement program to develop the motivation and the positive mindset you need based on your goals. The app allows you

to customize affirmations by recording them in your own voice and setting them to music.

6. Lose big

Keeping a food diary can double a person’s weight loss, according to Science Daily. To shed big pounds, tracking is key.

The Lose It app does just that. Consider it your daily go-to for tracking food, fitness and nutrition. Plus, as one of the hottest

food-tracking apps out there, you can take part community activities and competitive challenges with fellow members and have

access to coaches. The platform’s newest feature, Snap It, takes food-tracking to the next level by identifying nutritional data of

the food you’re eating by simply snapping a picture of it.

7. C’mon, get happy

With any lifestyle change, getting and staying on track takes discipline and self-control. The journey is tough – but definitely

worth it. To help get you through any bumps along the way, Happify brings you effective tools and programs to help you take

control of your feelings and thoughts. Once you download the app, Happify measures your current state of well-being and assigns

a number. From there, users can complete daily activities tasks and games to increase the number. The science-driven app aims to

retrain your brain to think positively by adopting new thought patterns.

8. Doctor recommended

Wish you could bring your doctor with you everywhere? With BariApps, you can. The app is tailor-made for bariatric patients.

BariApps works with surgeons and medical practices to created tailored post-surgery programs so doctors can more accurately

track your progress. Because every patient is different, this app connects to your specific weight loss plan. Doctors can trigger

reminders and action steps based on what you’re actually eating. Make the most out of every office visit with customized reports

based on real-time results. https://www.somabariatrics.com/blog/weight-loss-surgery/8-great-apps-to-get-after-youve-had-weight-loss-surgery/

Pre-Op Diet Guide: What to Eat Before Weight Loss Surgery

Pre-Op Diet Guide: What to Eat Before Weight Loss Surgery

September 15, 2017 - by Marisol Avendano - in Nutrition

About two to three weeks prior to any type of weight loss

surgery, most physicians will have their patients go on a

special pre-op diet. Doing so helps improve the safety of

the surgical procedure and makes it go smoother for the

surgeon and patient.

Why a pre-op diet is necessary

The diet’s purpose is to shrink the liver and reduce abdominal fat, which decreases the risk of complications during the surgery, according to the American Society for Metabolic and Bariatric Surgery.

After your bariatric surgery, you will need to follow a post-op diet to allow your stomach to completely heal and lose weight safely and effectively. This often consists of a diet that’s similar to the one you’ll follow before the surgery — which means the good news about a pre-op diet is that it prepares you for what you’ll need to follow after the surgery.

Following a pre-op diet also keeps you healthier post-op. This study of 881 bariatric surgery patients found that preoperative weight loss corresponds with fewer complications after surgery. In addition, if your bariatric surgery is covered by insurance, your carrier may require you to go on a special diet up to six months

before the surgery to receive coverage, as demonstration of your commitment to learn about nutrition and go to weight loss

appointments.

If you’re considering bariatric surgery for weight loss and improved health, here is the type of pre-op diet you can expect to

follow in the up to three weeks prior to the surgery.

What you can eat before bariatric surgery

While you may be tempted to binge on your favorite fatty, high-

sugar or high-carb foods right before the surgery, introducing healthy

options before the surgery helps you maintain your weight loss after

it’s done.

Depending on your size, the typical daily caloric intake pre-op will

be between 800 to 1,200 calories a day, and most of those will be

consumed via liquids. You’ll also want to get between 70 to 120

grams of protein, depending on your physician’s recommendations.

Because the calorie limit is likely much smaller than what patients

are used to, staying hydrated throughout the day is key to satiate

hunger, which is temporary and will subside over time. The following food items will help reduce liver size and fatty tissue and

prepare you for a healthy lifestyle; try these in the two to three weeks before your surgery:

Protein shakes. Protein helps you retain muscle and increases metabolism speeds. There are protein shakes on the market designed specifically for bariatric surgery patients which serve as meal replacements and can be mixed with water or skim, soy or nut milk.

Clear liquids. Besides water, you may drink low-calorie liquids like non-sugary water flavor enhancers as well as low-calorie sports drinks. Vegetable juice, vegetable broth or bone broth, which are savory low-calorie options to stave off hunger, may also be consumed.

Caffeine-free coffee and tea. These drinks must have no added sugar to them. Additions that are OK include small amounts of sugar-free sweetener and soy, skim or nut milk.

Sugar-free snacks. Sugar-free gelatin or popsicles may be consumed sparingly, up to once a day, before the surgery.

Low-calorie soups. Avoid soups with carb-heavy foods like pasta in them, and aim for vegetable or broth-dominant soups. Depending on your body mass index, you may be permitted to eat some lean meats or protein-rich foods like nuts in the early

days you’re pre-op. No matter what size you are, expect to be liquid-only for at least a week before your surgery and immediately

after. The earlier you can adopt a diet using mostly the foods above, the better you prepare your body to be used to the diet

immediately post-op and beyond.

Avoid these foods before weight loss surgery

A last hurrah of all your old favorite foods may be tempting, but know that not adhering to diet instructions from your weight loss

physician increases your risk of complications during surgery. A fatty liver makes weight loss surgery more dangerous. Stay safe

by steering clear of these foods.

Foods high in carbohydrates and starches. Bread, pasta, potatoes, pizza, cereal and rice should also be avoided.

Foods high in sugar. Besides chocolatey desserts, cakes, cookies and the like, do not allow sugary fruit drinks to enter your liquid diet. You should not only avoid packaged fruit drinks, but avoid the appeal of juicing fruit, since this can cause your daily caloric intake to increase quickly because of the amount of fruits you need for a small serving of juice.

Foods high in fat. Cheese, fried foods and fatty meats are all high in fat and calories and can wreak havoc on your digestive system. If you’re used to eating these types of foods, you may face some mental difficulties when you begin your pre-op diet. The good

news is, these decrease over time, and feel-good effects will start to supplant any hunger or cravings you have. As your body

starts to burn more body fat for energy rather than high-calorie sugar and carbs, those cravings will also decrease. A study of the

effects of a high-protein diet found that swapping protein calories for sugar/fat/carb calories increases satiety and appetite control,

which contributes to more effective long-term weight loss. https://www.somabariatrics.com/blog/nutrition/pre-op-diet-guide-what-to-eat-before-weight-loss-surgery/

Do five sets of ten of

each exercise.

Do five sets of ten of

each exercise.

Do five sets of ten of

each exercise.

Melissa’s Corner

We have had some exciting things happening this month:

First, we have a new location for our Prattville support group meetings. Please remember the new location is St

Mark’s Episcopal Church 178 E. 4th St. in Prattville. If you are coming down Main St., as if you are going to our previous meeting

location, the Doster Center, you would turn right at the next red light. Go past First Baptist Church and St. Mark’s Church is the

next church on the left across from Prattville Primary School. I want to say a huge THANK YOU to Karen Mitchell for her help in

securing our new meeting location.

Second Jackson Hospital is now a Blue Distinction Center as of Oct 1, 2019. What does that mean? That means any Blue Cross

policy requiring you to have your weight loss surgery at a Blue Distinction Center (i.e. EDU teacher policies) can now stay in

Montgomery versus going to Birmingham.

Jackson is the only Blue Cross Blue Distinction Center for weight loss surgery in the Tri-County area.

I am so glad that we have finally gotten rid of these 90 degree days. I don’t love the cold but I really don’t like to be hot. I could

take a sunny and 75 degree day anytime. The cooler nights make it good sleeping weather. I am very thankful for the rain we

have been getting, because it was way to dry this summer.

I want to thank everyone that has been calling me before they go get their labs done. It has helped out so much. Please

continue to do this! You can go to any Baptist, Jackson, Elmore, Tallassee Hospital or any Lab Corp. If you have any questions

about if or when you need to do your labs please call me.

IMPORTANT!! IMPORTANT!! IMPORTANT!!

1. Maintain a healthy, low calorie diet that is low in

carbs and fat, but rich in protein. Your water intake

should be at least 64 oz. per day.

2. Exercise (walking, jogging, swimming, biking, cardio, etc.) 1 hour per day, 5

days a week.

3. Take vitamins and prescribed minerals without fail.

4. Seek out help from a mental health care individual (psychiatrist, psychologist)

to learn new ways of coping with stress as needed.

5. If you are a lap band patient and you have had an adjustment to your band,

and start having problems keeping foods or liquids down that day, that night,

or the next day, CALL US IMMEDIATELY and let us know. Adjustments are

usually done on Tuesdays and Wednesdays and Thursdays when Dr. Mora is in

clinic. You MUST let us know by Friday if you are experiencing problems so Dr.

Mora can evaluate you before the weekend. Do not go over 24 hours without

reporting problems to us or you can damage your band.

6. If you are a gastric bypass patient, 3 months or more out from surgery,

have your lab-work done one week prior to your follow-up appointments.

7. Regularly attend support group meetings.

Please write a story of YOUR weight loss

story with pictures and submit to

Melissa @ Dr. Mora’s office for

publication in the newsletter. Submit

to melissa@morasurgicalclinic.com or

call the office @ 361-6126

IS THERE A TOPIC YOU WANT TO SUGGEST FOR OUR NEWSLETTER OR SUPPORT

GROUP MEETING? IT’S A GREAT TIME TO LET US KNOW!!! WE WANT TO HEAR FROM

YOU! The support group meetings and newsletters are for you, our patients. We want

to make sure you’re getting the information you want from both the meetings and the monthly newsletters. Send your

suggestions to Melissa at Melissa@morasurgicalclinc.com or call the office 361-6126

Search morasurgicalclinic

UPCOMING SUPPORT GROUP MEETINGS

FOR PRATTVILLE

**PLEASE NOTE! WE HAVE THE DATES LISTED BELOW FOR MEETINGS THROUGH DECEMBER 2020

NOW, SO MARK YOUR CALENDARS TO ATTEND! PLEASE NOTE LOCATION CHANGE!!

LOCATION:

St Marks Episcopal Church 178 E. 4th St Prattville, Al 36067

TIME: 6:00 P.M. -7:00 P.M.

DATE: 2019 October 28, November 18, December 16 2020 January 27, February 24,

March 23, April 27, May 18, June 22, July 27, August 24, September 28, October 26,

November 16 and December 21

PLEASE note all dates are subject to change due to availability of Dr. Mora or other

extenuating circumstances. We encourage you to call to check that the date has not

been moved ahead of time each month, especially if you live out of town.

Jackson Hospital Bariatric Support Group Meetings

Meet Monthly on the 2nd

Monday of the Month

11th Floor, Goode Building

5:30 pm- 6:30 pm

Hope to see you:

Nov 11 and Dec 9!

Bring your support person.

We will have monthly agenda items to help with your journey of new beginnings

For more information:

Erica Sears, MSN, RN

Bariatric Surgery Coordinator

Erica.Sears@jackson.org

334-293-4065

GUIDELINES FOR SUPPORT GROUP MEETINGS

Everything said and heard in the group will be treated with respect for the

participants’ privacy. What is said in the group stays in the group.

• Silence is acceptable. No one needs to say anything she/he does not wish to say. The

group is supportive rather than judgmental.

• The group offers respect for individual choices and experiences.

• Only one person talks at a time.

• Turn off all mobile phones and pagers.

• No one is allowed to dominate the conversation.

• The group facilitators’ roles must be respected.

• Begin and end meetings on time.

• The group is a safe place to share feelings, and to obtain and provide support,

information, reassurance and encouragement.

• The group is broadly defined. It is flexible; flowing with the participants’ needs and

interests, and provides an opportunity to reduce feelings of isolation.

• Bariatric surgery support groups are open to all persons going through the surgery

process, including family members and others in a supporting role.

• Although the results of going to the group can be therapeutic, the group is not meant to

replace individual behavior therapy.

• Every effort should be made within the group to resolve conflict arising from or during

group interaction.

If you have any concerns or questions after attending one of our meetings, please feel free to contact Melissa confidentially

by email at Melissa@morasurgicalclinic.com