VOLUME December 2014 - Mora Surgical Clinic · 2015. 1. 6. · official Christmas. Last year he spent 9 days in the hospital and missed his first Christmas. So you can bet Mimi and

VOLUME 15 December 2014 NUMBER 12

Editorial Notice

Editorial Staff:

Melissa Grant

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: [email protected]

If you no longer wish to

receive Bariatric Bulletin, contact:

[email protected]

Bariatric Bulletin,

This newsletter is published

monthly for Dr. Parham Mora 645 McQueen Smith Road.

Suite 205 Prattville, Alabama 36066

Bariatric Patients Should Take Supplements For Eye Protection

Obese patients who have undergone bariatric surgery to shed weight should

take the supplements prescribed to them to protect their eyes. Taking in too

little Vitamin A, in particular, could in some cases actually cause night

blindness, dry eyes, corneal ulcers, and in extreme cases total blindness.

This advice comes from Rui Azevedo Guerreiro and Rui Ribeiro of the Centro

Hospitalar de Lisboa Central in Portugal, who reviewed what little research

there currently is on the occurrence of eye conditions following bariatric

surgery. The review is published in Springer's journal Obesity Surgery.

Three different types of bariatric surgery are performed to help with weight loss in obese patients: restrictive (such

as adjustable gastric banding and gastric sleeve), malabsorptive, and mixed procedures (including Roux-en-Y gastric

bypass and biliopancreatic diversion) that combine the first two types of surgeries.

One of the drawbacks of these operations is that patients can develop nutrient deficiencies. This happens, for

example, when patients vomit more often, eat less or develop food intolerances. People who have had restrictive

bariatric surgery, for instance, often follow an unbalanced diet which subsequently influences their intake of the

correct combination of vitamins and micronutrients. Moreover, malabsorptive and mixed bariatric surgeries decrease

the surface area of the small intestine that plays an important role in the uptake of nutrients. As a result, too little

vitamins and micronutrients may be absorbed properly by the body.

Nutrient deficiencies caused by bariatric surgeries can, in the mid to long term, cause eye-related complications that

can affect almost every component of the optic system. It can lead to conditions such as night blindness, ulcers,

scarring and changes to the cornea, involuntary eye movement (called nystagmus), paralysis of the eye muscles

(ophthalmoplegia) or dry eyes.

It is the lower intake of especially vitamins A, E, and B1 (thiamine) and copper that worry Azevedo Guerreiro and

Ribeiro, as these help with the normal functioning of the eye and optic system.

Vitamin A deficiency, in particular, is linked to eye-related complications developing after bariatric surgery.

However, the results of the handful of studies done on the subject is inconsistent. In general, Vitamin A deficiency

and eye-related complications seem to be more prevalent after malabsorptive bariatric surgery.

"There is a risk that bariatric surgery patients, who do not take the vitamin and mineral supplements prescribed to

them, could develop eye-related complications because of nutrient deficiencies," emphasizes Azevedo Guerreiro.

"Such complications after bariatric surgery are not frequent, but if undetected, they can have devastating

consequences for the patients."

"The real prevalence of these complications is unknown but the rarity of clinical reports that link nutrient deficiency

with eye-related complications could also mean that no one is looking for such problems," adds Ribeiro.

http://www.surgicalproductsmag.com/news/2014/12/bariatric-patients-should-take-supplements-eye-

protection?et_cid=4296116&et_rid=650448428&location=top

Study: Bariatric Surgery May Alter Taste Buds

Stomach-shrinking bariatric surgery may also foster changes in a person's taste buds, which could help them lose

weight and keep it off, according to a new study.

Researchers at Stanford University School of Medicine in

California found that patients who reported a decrease in taste

intensity after bariatric surgery had lost more of their excess

weight after three months than those whose sense of taste became

more intense.

The results were reported Nov. 4 during Obesity Week 2014,

hosted in Boston by the American Society for Metabolic &

Bariatric Surgery and The Obesity Society (TOS).

The researchers said they did the study after noticing that many

of their patients reported changes in their perception of taste after bariatric surgery, including both increased

sensitivity to tastes and new aversions to foods.

The study included 55 obese patients undergoing bariatric surgery and a comparison group of 33 healthy non-obese

people who didn't have surgery. At the start, all participants took a taste test using flavor-saturated paper strips to

gauge their ability to identify sweet, sour, bitter, salty and pleasant savory (umami) tastes.

The bariatric surgery patients were retested at three, six and 12 months after surgery.

Even before surgery, the tests showed the obese patients were "uniformly less taste sensitive than normal weight

patients,” said Dr. John M. Morton, chief of bariatric and minimally invasive surgery at Stanford, who worked on

the study. "Obese patients may seek to derive satisfaction through volume rather than taste appreciation.”

The majority (87%) of patients reported a change in taste perception after bariatric surgery, with 42% saying they

ate less because food didn’t taste as good. “After surgery, patients did note less preference for salty foods,” Morton

said.

Those who said their taste intensity decreased after surgery lost 20% more weight over three months, than those

whose taste intensified.

“The study provides excellent new insight on taste change after bariatric surgery,” Dr. Jaime Ponce, medical director

of bariatric surgery at the Hamilton Medical Center in Dalton, Georgia, and past-president of the ASMBS, noted in a

conference statement.

“More research is needed to see how we can adjust for taste perception to increase weight loss,” he added.

Morton told Reuters Health, "Future strategies may include teaching patients taste appreciation to derive satisfaction

with less food volume."

http://www.surgicalproductsmag.com/news/2014/11/study-bariatric-surgery-may-alter-taste-buds

Get Killer Abs

Everybody wants defined abs. Good thing there are so many different abdominal exercises to choose from — you'll

never get bored as you work your way toward washboard abs!

Here are three versions of the plank, a move that works the lower back, chest, and shoulders in addition to the

rectus abdominis.

Basic Plank

(beginner)

Start in a push-up position, but keep

your hands directly under your

shoulders instead of outside your chest.

Legs are extended straight behind you,

with feet together. You are balancing on

your palms and the balls of your feet.

Hold this position for as long as you can,

working your way up to 1 minute. It's a lot harder than it sounds!

Plank Twists

(intermediate)

Start in plank position. Maintaining this position, exhale and rotate your

torso by bringing your right knee in toward your left armpit. Return to the

starting position, then repeat, bringing the left knee toward the right

armpit. Plank twists work not only the rectus abdominis but also the

internal obliques.

Extended Plank

(advanced)

Start in a basic plank position, but instead of placing your

hands under your shoulders, bring your hands together and

place them on the floor in front of you (about 3 inches in

front of your head). This variation places much greater

emphasis and concentration on the rectus abdominis

because you're not able to use your arms as pillars to

support your body weight.

http://www.jillianmichaels.com/fit/lose-weight/washboard-abs?xid=nl_LosingItWithJillianMichaels_20141211

"Your life becomes the thing you have decided it shall be." – Raymond Charles Barker

About Raymond Charles Barker

Raymond Charles Barker was an influential American minister and author in the mid-twentieth century. He wrote such books as The

Power of Decision and Treat Yourself to Life, on ways to change subconscious patterns. He became president of the International

New Thought Alliance in 1943, a group practicing the religious philosophy developed in the late 1800's by Phineas Quimby, with

early proponents including Ralph Waldo Emerson. Unity Church and Divine Science are among its later offshoots. He founded the

First Church of Religious Science in Manhattan in 1946 and served as its minister until 1979. He died in 1988 at the age of 77.

Crock-Roasted Chicken with Rotisserie Rub From Prevention Guide Slow Cooker Recipe Book 1 whole chicken (3 1/2 – 4 pounds)

1 Tb. Paprika

1 ½ tsp onion powder

1 Tb. garlic powder, or 3 cloves garlic, pressed

1 tsp salt

½ tsp ground black pepper

Rinse chicken and pat dry, removing any visible fat

.

Discard giblets and neck. Coat 4-quart (or larger)

slow cooker with cooking spray.

Combine spices in a bowl and stir in warm water by

the teaspoon-full until a thick past forms. coat the

chicken inside and out with the seasoned paste before

placing in cooker, breast-side up.

Cover. Cook on low 6-7 hours or on high 3 ½ - 4 ½

hours, or until thermometer inserted in thickest part of

thigh registers 180 degrees. Remove chicken from

cooker. When cool enough to handle, remove skin and

serve.

Nutrition: 4 Servings Cal: 230; Pro: 41; Carb: 2; Fib: 1; Fat: 6

http://georgetowncommunityhospital.com/sites/www_georgetowncommunityhospital_com/Uploads/Crock_Pot_Recipes.pdf

Roasted Brussels Sprouts Recipe with Balsamic, Parmesan, and Pine Nuts

(Makes 3-4 servings)

Ingredients:

1 lb. brussels sprouts, trimmed and quartered

2 T olive oil

1 T balsamic vinegar

2 T Parmesan cheese (preferably fresh grated; use more or less to taste)

1 T pine nuts (preferably toasted, could substitute other nuts of your choice)

Instructions:

Preheat oven to 450F/230C.

(You can also roast the brussels sprouts at a lower temperature for a longer time if you need to cook other things in

the same oven.)

Trim brussels sprouts, remove any discolored leaves, and cut into quarters (or halves if they are small.) Whisk

together the olive oil and balsamic vinegar. Put sprouts in mixing bowl and toss with the olive oil-balsamic mixture.

Spray the roasting pan with olive oil or non-stick spray. Arrange sprouts in a single layer on roasting pan, and roast

15-20 minutes, turning occasionally, or until sprouts are slightly crisp and golden brown on the edges.

When sprouts are nearly done, toast pine nuts in a dry pan about 2-3 minutes, until barely starting to brown. (Be

careful, they can go from lightly brown to overdone quite quickly.) Put cooked sprouts back into mixing bowl and

toss with Parmesan cheese. Arrange on serving plate and sprinkle with pine nuts. Serve hot.

http://www.kalynskitchen.com/2007/11/roasted-brussels-sprouts-recipe-with.html

Melissa's Corner

Wow, Christmas is just 10 days away! Where has the time gone? This will be Ian's (my grandson) fist

official Christmas. Last year he spent 9 days in the hospital and missed his first Christmas. So you can bet

Mimi and Pap Pap will make sure he enjoys this one. I tell you that boy just amazes me every day with

how smart he is. I swear they are born knowing how to use cell phones and computers. He gets my

phone and knows how to turn it on and use it! He know all his body parts and his momma is teaching

him his colors. He knows where his Mimi works, and every time they

drive by the medical park he says "Mimi". It's so cute!

I'd like to wish everyone a very Merry Christmas and a Happy New

Year. May you all have a blessed holiday season.

Please remember if you have any issues over the holiday's call the

office and if it's after hours

PLEASE go to Prattville Baptist

Hospital.

To reach me it is [email protected]. If you don’t

have Email please make sure I know. This is how I do a lot of my communication with you.

Search morasurgicalclinic

Don't forget about our website www.morasurgicalclinic.com

We will feature a new weight-loss story every month.

You can now see us on the big

screen at the Prattville Promenade

Look for us on the digital billboard on the

corner of Cobbs Ford Rd and Hwy 82.

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 Mondays and Wednesdays 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 [email protected] or call the

office @ 361-6126, ext 2

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 [email protected] or

call the office 361-6126

UPCOMING SUPPORT GROUP MEETINGS

**PLEASE NOTE! WE HAVE THE DATES LISTED BELOW FOR SEMINARS THROUGH SEPTEMBER 2015

NOW, SO MARK YOUR CALENDARS TO ATTEND!

LOCATION:

Prattville Doster Community Center

424 South Northington Street, Prattville, AL.

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

DATE: 2014 December 15 2015 January 26, February 23,

March 23, April 27, May 18, June 22, July 27, August 24 and September

28

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!

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 [email protected]