Author: James Donaldson

Top 5 Gastric Sleeve Surgery Complications

January 14, 2017

Obesity is said to be a silent killer because it poses increased risk for tons of co-morbidities like cancer, hypertension, diabetes, sleep apnea, and hypercholesterolemia.

Gastric sleeve surgery is relatively new amongst the lineup of approved weight loss surgical procedures but it has already raked in a lot of positive reviews from patients and medical practitioners alike. This is said to produce around 60% of rapid weight loss in the first year after having undergone surgery. This is proven to be a safe and effective weight loss procedure alongside gastric bypass and Lap Band.

Weight loss surgeries such as the Gastric Sleeve carry some risks and complications alongside the benefits of a slimmer and healthier body.

Check out the top 5 gastric sleeve surgery complications:

Deep Vein Thrombosis. Blood clots can happen right after any surgical operation. This is likely to happen with impaired blood flow due to lack of mobility. Signs and symptoms of thrombosis would include loss of sensation, pain, swelling, redness, paleness, and paralysis. This is very alarming because it could trigger heart attack, stroke, and could even lead to death. It is advisable to stop smoking and also to remain physically active right after surgery.
Staple Line Leaks. This could happen at the first week after surgery. Physicians would often take precautionary measures and double check on the staple line with gastric sleeve surgery to avoid leakage. There is a minimal risk or around 2.4% probability that staple lines would occur postoperatively but still needs caution. If the patient experiences dyspnea, increased heart rate, and fever – call 911 right away.
Stricture. This pertains to the inflammation of the stomach lining and opening which restricts food passage. Common signs and symptoms to watch out for are the following: nausea, vomiting, food intolerance, and difficulty in swallowing. Strictures can be serious but when detected shortly after surgery, this can be treated effectively rest, intravenous fluids, and nothing by mouth.
Surgical Site Infection. If the patient is obese, this poses increased risk of wound site infection. This is considered to be the most common gastric sleeve surgery complication which happens in relatively 10% to 15% of most cases postoperatively. If you observe redness and heat at the surgical site, fever, dizziness, or increased hear rate – call your doctor immediately for treatment to avoid necrosis and further complications.
Gallstones. This is also a common complication seen in Gastric Sleeve patients which occur in 23% of most cases usually within two years postoperatively. Most patients who have developed gallstones would exhibit signs and symptoms such as vomiting, pain, nausea, bloating, and heartburn. A surgical operation could follow with the development of gallstones to avoid severity of complications.

Gastric Sleeve surgery is considered to be the safest weight loss procedure today because it has the lower reoperation and complication rates as compared to other surgical methods for trimming off extra pounds. Complications can happen at any point during or after surgery and it is best to take heed of the signs and symptoms of complications to know when to seek medical help.

How to Deal with Loose Skin after Gastric Sleeve Surgery

November 8, 2016

As you add up in years, the skin loses its elasticity. You would notice sagging or loose skin especially after having undergone gastric sleeve surgery. This is albeit normal because of the weight loss experienced post-operatively. This also means that the surgery was effective and you have lost a considerable amount of weight even on a short notice. Depending on your age at the time of surgery, your skin may not be that elastic enough to respond well with the weight loss happening after going under the knife and thus result to loose skin.

Here’s what you can do to deal with sagging or loose skin after gastric sleeve surgery:

Build more muscles by being actively involved in a regular workout or exercise program that works specifically on problem areas of the body like in the stomach, under the arms, and buttocks. Tone and tighten your muscles by engaging in resistance or weight training and weightlifting. Try squat exercises for the lower body, lunges for the upper thigh, planks for the stomach, bicep curls for the arms, and crunches for the abs.
Be patient. As doctors would say – experiencing loose skin is normal and is even a positive indication that you are losing weight all at the right places. If you want to correct the sagging skin by surgery, you will have to wait for 12 months before you can get a surgical remedy to improve loose skin. You should allow ample time for your body to recover and stabilize. By that time, the skin could have possibly tightened up on its own and would not warrant any surgical intervention.
Use salt scrubs. This is said to be very effective in improving skin elasticity after gastric sleeve surgery. You can use sea salt scrubs or any other variety of salt scrubs in the market. Indulge in a salt scrub at least twice every day while you are in the shower and see how it transforms your sagging skin quite effectively. Scientists believe that the use of salt scrubs improves and increases blood flow; which in turn helps tighten and make the skin firmer.
Massage Therapy. Pamper yourself by having a deep and invigorating massage therapy which does not just tighten up the skin but also helps you relax and de-stress after long hours of work.
In order to achieve a healthy, glowing, and firm skin, you need to drink lots of water. Avoid drinking too much caffeine or soda which can be dehydrating. You need to keep up with your required water consumption in order to achieve an elastic skin even after gastric sleeve surgery.
Full or Partial Body Lift. Consult your doctor if you would require or need a full or partial body lift to help improve the condition of your sagging skin. Weigh your options together with your physician to determine what would work for your body needs.
Practice Yoga. Focus on your core by doing yoga every day or at least thrice a week. Yoga helps eliminate stress and help with your flexibility which in turn improves the appearance of your loose skin.
Fruits and Veggies. It is recommended to eat at least five servings of fresh fruits and vegetables every day to improve skin elasticity and keep you well-nourished. Fruits and veggies have high water content which keeps your skin well-hydrated in the process.
Tummy tuck or other forms of corrective surgery can be considered if the sagging or excess skin does not improve even after six months or longer. Consult your physician for recommendations on surgical interventions that would fit your health condition.

Knowing what to expect after having gastric sleeve surgery would help you deal effectively with the upshots. The above tips would greatly benefit not just the appearance of sagging skin brought about by weight loss but also improve your overall health.

Tips to Dining Out with the Gastric Sleeve

July 8, 2016

People would think that after having undergone gastric sleeve, one would not be able to go back to an enjoyable dining experience or even relish eating out. Yes, there should be adjustments or modifications made to diet or meal choices but this is not supposed to hurt your lifestyle or socialization which includes dining out with family and friends like routine.

Eating out sure has been part of practically everyone’s lifestyle and is even squeezed in between busy schedules. Do note that even with gastric sleeve, you can still create great memories while dining out with people who matters. Beat the myths and make sure that you have fun while eating out even with gastric sleeve by following these helpful tips:

1. Carry around your WLS card. Make sure that you have with you your Weight Loss Surgery (WLS) card signed by your physician that informs restaurants that you underwent a weight loss procedure like gastric sleeve that has minimized your stomach capacity and that you need to order smaller meals than usual servings. You can discreetly hand your card to the waiter while placing your orders. Ask for recommendations on healthier meal choices. Restaurants give discounts with patients who present their WLS card upon ordering meals. A number of restaurants accept these meal cards which have actually been around since 1990’s. Even buffet restaurants with eat-all-you-can concepts offer discounts for patients with WLS card.

2. Check out restaurant menu online before heading out. Several restaurants have their menus available online on websites or fan pages that will help you sort out meals before you eat out. It certainly helps to plan ahead and check out the healthy meal options which could even have detailed nutritional information to guide customers which one to pick among the roster of delicious eats. This will help you decide and order efficiently when you decide to dine out with family and friends. More so, this also helps you keep track of your budget.

3. Be aware of “Family-style Concepts” in meals. It’s alright to go for family-style or shared concepts in meals where there are different meals served in large platters which is suitable for groups; as long as you know how to manage and control your consumption. It would be helpful to ask for an entrée plate and keep your food choices at a minimum and fill the entrée plate once.

4. Focus on lean proteins. When dining out, try to focus on ordering meals that are high in protein such as chicken, fish, or turkey; which is necessary in order to meet your daily nutritional requirements especially for patients who have underwent gastric sleeve.

5. Avoid empty calories. DO away or minimize drinking alcoholic beverages or softdrinks which will provide no nourishment and are ridiculously high in sugar and fat content.

6. Refuse complimentary bread and ask the sauce on the side. Most restaurants offer complimentary bread before the main course. Politely ask the waiter that it’s okay not to serve bread on the table. Avoid butter too. Also, keep it low on the dressings or sauce. One way to do it is to ask the waiter to place the dressing on the side so you can easily control the amount you consume. Condiments are beefed up with hidden calories that you won’t need right now especially after undergoing gastric sleeve.

7. To-go meals. If you have leftovers and can’t finish your platter – no pressure. Don’t allow yourself to feel obligated to conform and finish up your meal especially if you have been given a large portion. You can share it with a companion or you could package the rest of it for you to take away and eat at a later time. You can eat the rest of it at home as a midnight snack prepared in small servings.

8. Ask questions. Probe the waiter and don’t be intimidated to ask about how your food was prepared (go for food that is baked, broiled, roasted, or grilled rather than fried); or even the basic ingredients. More people are now becoming health conscious which has prompted most restaurants to be aware of the ingredients they pop into the pan and serve only the good stuff or healthy components stuffed with protein which is beneficial for people who underwent bariatric surgery or gastric sleeve.

9. Eat slowly. Eating out is not a race so it is best to eat at a slow pace and carefully chew and break down your food to liquid consistency so it won’t disturb or irritate your stomach lining. Great conversations with colleagues, friends, and family would help you steer clear from overeating and hurting your diet. Most dieters and those who underwent gastric sleeve opt for appetizers, salads, or soups rather than ordering main entrees which would not have the ideal or recommended servings right for your tummy space.

10. Share meals with a friend. It’s really hard to avoid eating out especially if it has been a part of your lifestyle; but you can always stick to a diet plan by sharing meals with a buddy. You can also split the bill; which may prove to be fun and cost-effective.

While eating out after having undergone gastric sleeve could prove to be a toll for patients, you can beat the stress by planning ahead and focusing on enjoyment of the dining experience without neglecting diet restrictions. Going out to dine has always been customary and even habitual for a lot of people because apart from the fun, entertainment, and gastronomic experience, this is also convenient for people who are always on the go.

It’s really hard to avoid and ignore restaurant doors especially if you happen to go hungry while traveling or on your way to work; but you can always make the necessary modifications on your food choices and opt for healthy alternatives so you can still lavish and splurge on dining out and keeping abreast with social connections.

For more on dieting and eating with the gastric sleeve surgery, check out our Gastric Sleeve Diet articles.

Average Weight Loss After Gastric Sleeve Surgery

April 4, 2016

The sleeve has been considered the best weight loss option there is as compared to fad products in the marketplace. Gastric sleeve surgery tops the list of obese patients mainly because it does not require any long-term maintenance as compared to the laparoscopic band. From 2010 up to the present year, gastric sleeves have been very in-demand among obese patients who are looking for the easy route to that well-coveted hourglass figure.

Going under the knife is, more often than not, regarded as the last resort when it comes to weight loss options. Many people are confident though with gastric sleeve surgery because this is known to be at least 99% effective in trimming down excess fat – which is a good number to begin with.

Not everyone is qualified to undergo bariatric surgery. You must be physically, mentally, and emotionally prepared for the surgery or this might not work as planned. The following are specific requirements that must be strictly met to determine if you are eligible for gastric sleeve surgery:

Extremely obese individuals are those who have a BMI greater than 35 to 40. If you belong to this category, then you prequalify to undergo gastric sleeve surgery.
You must be at least 16 years old.
Must have no underlying medical condition that potentially causes your being obese.
Must be free from any gastroesophageal diseases.

The human stomach is shaped like a pouch which can hold around 2 to 3 liters of food. Gastric sleeve surgery makes use of a stapling technique or device which leaves only 10% of the stomach as 90% is removed to form a vertical sleeve which can hold only around 50 to 150ml of food contents – this means you get to eat in smaller portions and yet completely enjoy the dining experience. Although the stomach has been reduced in size, it still functions normally or in the same way as before.

The gastric sleeve surgical procedure enables you to crave for less food without affecting enjoyment for gastronomic grubs. Here are the involved methodological processes that allow you to lose weight with the sleeve procedure:

Controls hunger. The sleeve does not just limit the stomach’s capacity but it also reduces appetite as it also affects a person’s biochemical response to food. As such, you will no longer feel hunger pangs in between meals.
Shifts to healthy food options. Patients choose to eat healthy as the stomach triggers reduced cravings for fatty- and sugary-rich food choices that usually cause weight gain.
Encourages you to eat in small portions. You are able to curb your cravings and prevent overeating because you feel full even with small servings. This proves to be economical too while you get to splurge on the nutritional benefits of a well-planned diet program suited for those who have undergone gastric sleeve surgery. You will have to undergo phases of feedings to allow your gut to heal completely.

What is the average weight loss after gastric sleeve surgery?

Nonsurgical weight loss options will only give you 10% satisfactory results as compared to going under the sleeve surgery wherein patients are guaranteed to lose an average of 65% to 70% of their excess body weight. It would be motivating to note that a number of patients have seen around 100% weight loss following specific lifestyle and nutrition modifications along with the sleeve surgery.

Advantages of the Sleeve:

You get to lose weight effectively. The main purpose of going under the gastric sleeve surgery is to be able to lose the weight and keep it off – the procedure is a certified brand in itself. You will lose weight of around 65% to 70% on average as compared to other bariatric surgical procedures that could render less optimal results.
Experience fewer complications as compared to other surgical procedures. This is considered to be the most popular bariatric surgical procedure because it poses less to null risks while going under the knife and postoperatively. You can be discharged from the hospital in a matter of 2 days.
Requires few doctor visits. The sleeve does not require full-length monitoring because it has less potential health risks postoperatively as compared to the gastric bypass and other similar procedures. This would only require a few appointments with your physician which is usually limited to the first few months following surgery.
This effectively manages obesity-related health problems. Some gastrointestinal illnesses related to obesity are found to improve or go into remission such as diabetes mellitus in patients.

Disadvantages of the Sleeve:

Potential weight gain. There is very little possibility that a patient can gain weight after some time following the sleeve surgery. There are relatively very few insignificant weight gain accounts with patients who have had gastric sleeve surgery. They only get to gain a few pounds but do not revert to previous weight unlike gastric bypass patients who tend to gain their old weight and even add up some excess pounds on the weighing scale.
Potential leak from staple line. The first two weeks after sleeve operation is crucial to recovery. If there are any leaks, it would be much visible at this point. Leaks from the staple line is considerably rare or only around 1% of all cases but it still pays to be extra attentive and careful especially during the first few weeks after the gastric sleeve surgery.

The gastric sleeve surgery is regarded to the most popular bariatric surgery in Australia and the United States because it has fewer health risks, faster recovery rate, and generates effective weight loss results.

Most people prefer the sleeve operation than other bariatric forms of surgical procedure because it is fairly predictable, poses less health risks, most effective in losing weight, and improves other obesity-related health problems.

This is a keyhole operation which means patients require less pain management, fewer visits to the doctor, and speedy recovery rate as compared to other invasive types of surgery which is definitely a cost-effective weight loss treatment that will provide immediate results.

Joint Health Before and After Gastric Sleeve Surgery

February 26, 2016

According to a study in Arthritis Care and Research, osteoarthritis and rheumatoid arthritis were on the rise, along with other diseases. In just 5 years, the diagnoses of those joint diseases increased by 34%. Hospitalizations of patients with those diseases also increased, by 22%. The study concludes there is a high possibility that these are linked to obesity.

Obesity-Related Joint Diseases

Osteoarthritis

Between joints, which are where two bones meet, are cushions of cartilage. These cushions are the “shock absorbers” of the body. Osteoarthritis occurs when these cushions become worn out over time. It is an inevitable result of aging. However, certain conditions can cause early osteoarthritis through over-stress of the cartilage. Obesity is one of these. The added weight of a person puts more stress on the cartilage, wearing it out faster.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, meaning your immune system mistakes your healthy cells for foreign ones, and attacks them. Rheumatoid arthritis causes inflammation of the joints, swelling around the area, and of course also pain in using those joints. It was found that those who have a BMI (Body Mass Index) of 30 and above were more at-risk of rheumatoid arthritis. The body’s fat-storing (adipose) cells are a factor in autoimmunity.

Gout

Gout is caused by uric acid building up as crystals in the joints, due to too much uric acid in the body. This uric acid, a result of the body breaking down purines in certain kinds of fish and in beer and wine, usually passes through urine. However, obese people may have a high buildup of uric acid which the liver and kidneys can no longer keep up with. In certain people, the uric acid will crystallize and cause swelling and pain around the joints.

The Effect of Gastric Sleeve Surgery on Joint Health

There are some cases in which proper diet and exercise can no longer cope with obesity. Joint disease is one of those cases. Attempting the normal forms of exercise, even light jogging or walking, may cause joint injuries you cannot fully recover from. Remember, using your joints increases the body weight being placed on them.

For example, consider your standing body weight as the normal body weight. When you walk on a straight path, you are placing 1 and ½ times your body weight on your joints. Just getting out of your chair can put 2 and ½ times your body weight on your joints. The more strenuous the exercise, the worse the effect on your joints.

Gastric sleeve surgery causes an average weight loss of 30% from your full BMI. Just 5% weight loss causes an 18% improvement in joint disease symptoms. In your pursuit of a life of health, gastric sleeve surgery is a great first step. It not only clears the way for effective dieting by reducing the stomach size, but also lowers the risks to your joints as you begin to exercise.

Gastric Sleeve Surgery: A Way to Joint Health

Joints do age and become less healthy over time. However, no one wants their joints to become difficult to use before it is time for them to stop. For an energized lifestyle that stretches as long as you can manage it, gastric sleeve surgery is one way to reduce wear and tear on the joints, and increase your chances of doing what you want to do in life.

Long story short, gastric sleeve joint health is a major reason to have gastric sleeve surgery.

Do I Need A Gastric Sleeve Forum?

February 16, 2016

Sometimes, the decision to have life-changing gastric sleeve surgery feels like a lonely one. Family and friends, who do not fully understand your decision, might question it. Even if they are supportive, they may still voice their own doubts about the surgery to you.

Sometimes, thinking about all those questions and challenges is stressful. You might decide that weight loss is a personal issue, and so you might as well keep the surgery, and everything about it, between yourself and your surgeon. That is not such a good idea, for many reasons. Believe it or not, social support can even help you lose weight.

Why Do I Need To Join A Gastric Sleeve Forum?

More Likely to Complete and Maintain Treatment with A Gastric Sleeve Forum

In a study in the Journal of Consulting and Clinical Psychology, patients who joined weight loss programs with friends, and patients who joined alone, were tested. The patients who joined with friends were given additional social support by the clinic. 95% of them completed the treatment, 66% maintained full weight loss.

In contrast, only 76% of the patients who joined alone completed the treatment. Only 24% of them maintained full weight loss. Patients who were constantly encouraged, and who faced healthy competition, were more successful in weight loss programs. A gastric sleeve forum gives the same kind of support, from others who are going through the same challenge.

More Likely to Lose Weight with A Gastric Sleeve Forum

It might sound too easy, but the science proves it. In an article published in The Journal of the American Medical Association, two groups were compared. One was a self-help group, while the other group had regular meetings with a support group.

The “commercial group,” the weight loss group with a support system, lost more weight than the other. They lost a minimum of 4.3 kilograms, compared to the 1.3 kilograms lost by the self-help group. More than that, members of the group who attended at least 78% of the support sessions lost 5 kilograms minimum, instead of 4.3 kilograms.

There are even more studies that confirm this. livescience determined that patients of weight loss programs lose an average of 4.9 percent of their total body weight. If they are in a weight loss program with a social support group, they lose an average of 7.5% of their total body weight. Success was a closer goal with that support group.

The Trevose Behavior Modification Program shows how well aggressive group support and healthy competition can work as well. Under their program, which requires weekly attending of the support meetings or the program ends, patients lost 19 percent of their total body weight.

The Gastric Sleeve Forum: An Ingredient for Success

There are many ingredients for weight loss success. However, having a gastric sleeve forum is one of the best of those. Instead of withdrawing into yourself and hoping you can lose enough weight before anyone notices, find a supportive gastric sleeve forum. You can get answers to questions, build relationships, and most importantly, find strength and encouragement.

Gastric Sleeve Recovery

February 3, 2016

The day you wake up from gastric sleeve surgery is day one of your new life. How well your new life goes is mostly up to you, but you will not be able to prepare for it unless you know what is expected of you after surgery. First, remember: you will lose weight, and you will recover–it is only a matter of time. Do not lose hope during the recovery period.

What Kind of Pain Should I Expect During Gastric Sleeve Recovery?

You should not wake up from surgery with too much pain. There should still be quite a bit of anesthesia in your system, enough for you to wake groggy but with only dull pain. However, as the anesthesia wears off, the more throbbing pains will start.

The pain should be localized where the surgical incisions were made. The largest incision is most likely the main cause of pain, so move carefully for the first few days. If you have pain anywhere else–back, shoulders–tell your surgeon. This pain is irregular.

Should I Follow The Prescribed Diet Strictly During Gastric Sleeve Recovery?

Yes. Follow the diet your surgeon and-or dietician set you. This is not only so that you lose more weight (which you definitely will if you follow this). The diet also protects you from any complications after gastric sleeve surgery.

The number one danger you are guarding against, after surgery, is the risk of gastric leak. Gastric leak happens when the staples holding the cut in the stomach together are overstrained, and let stomach acid into the rest of the body. Heavy foods put your stomach at risk of gastric leak if you do not give it time to heal.

Is Exercise Important During Gastric Sleeve Recovery?

Exercise is extremely important. You are even encouraged to walk around your hospital room the day you wake up from surgery. The movement reduces pain in the long run, because it helps your body heal much faster.

Exercise also grabs the momentum your gastric sleeve surgery gives you, and runs away with it. Since you will already be on a diet, exercise will help you burn calories faster, heal faster, and reach your weight loss goals much sooner. The sense of accomplishment after every finished exercise also gives you encouragement for everything else.

Would A Support Group Help Me During Gastric Sleeve Recovery?

A support group, whether online or in-person, would definitely be a great help to you. Your first line of defense should, of course, be your family and friends. Ask them to accompany you to doctor’s appointments and seminars, be open to them about your emotions, and keep them involved in your life.

The second line of defense is a support group made of people who have gone through the same surgery. A group moderated by a health professional specializing in weight loss surgery is perfect if you need a space in which to ask questions and air problems freely.

Gastric Sleeve Recovery: The Beginning of New Life

Gastric sleeve surgery can be one of the best decisions you have ever made. It will definitely give you a headstart at the new life you are planning for yourself. The weeks after surgery, however, are sometimes the worst. All the changes may cause mood swings and emotional imbalance. Use the instructions on exercise and diet as a lifeline, and just keep going. Great results are inevitable.

Gastric Sleeve Complications

January 30, 2016

Before you decide on gastric sleeve surgery, you need to know as much as you can about the surgery itself. It will help you understand whatever pre-operation tests and procedures you need to go through. You should also be fully aware of the very possible complications of gastric sleeve surgery. In that way, you will be able to help reduce them as much as possible.

Gastric Sleeve Complications

Gastric Sleeve Complications During Surgery

Allergic Reaction

1 in 5,000 people are allergic to certain kinds of anesthesia. If you are already allergic to something, be it pollen, antibiotics, or certain drugs, you are more likely to have an allergy to anesthesia as well. Tell your doctors exactly what you know you are allergic to. They will try to find the best anesthetic agent that will meet your medical needs.

Even if you are already asleep when the allergic reactions begin, the physicians should be able to catch your reaction. There will be rashes, and some differences in your breathing patterns. They can then change the anesthetic agent.

Abdominal Adhesions

If you have had prior surgery, or an abdominal injury that resulted in a cut to the abdomen, you may have abdominal adhesions that could make surgery more complicated. Abdominal adhesions are fibrous tissues that cause your organs and tissues to stick together. They are caused by scar tissue automatically growing to protect places it felt were injured.

When you have gastric sleeve surgery, your surgeon may find that some of your organs and tissues have adhered to one another, making it more difficult for him to perform the surgery. Your surgeon will have to cut through the adhesions to move the organs around. You are also almost definitely (a 93% chance) going to have abdominal adhesions after surgery.

Accidental Gastric Laceration

One of the risks run by anyone in surgery is that of an accidental cut where the surgeon did not mean to place one. During gastric sleeve surgery, the surgeon may accidentally inflict a wound in the stomach.

As long as the surgeon checks for such lacerations and fixes it (stopping the bleeding, stapling and sewing it), there should be no problem. However, the laceration may go unnoticed and the surgery completed without the laceration being fixed.

Uncontrolled Bleeding

Every surgery has a clear risk of blood loss. When surgeons are performing a procedure, they automatically avoid the largest blood vessels to prevent their patient bleeding out. However, in the case of any accidental injury to a major blood vessel, they will need to close it. If they take too long, or if the closing does not work, the patient risks too much blood loss.

Liver Injury

Obese patients tend to have more enlarged livers than is healthy. A pre-operation diet brings down the liver size, but not to healthy levels. Surgery puts the liver at risk of injury. It may be accidentally cut by the surgeon, or suffer trauma from the surgery. Liver injury can be fatal if there is liver failure.

Post-Surgery Gastric Sleeve Complications

Wound Infection

After surgery, you will have several (if laparoscopic) or one (if open) surgical cuts on your abdomen. Your surgeon will stitch them shut, so the wounds have time to heal. Your challenge is now how to keep the area clean and dry to avoid infection.

Open wounds let bacteria into the body. If an infection begins, you will struggle with fever and risk of other diseases. The wound will also take longer to heal and close. If you have diabetes, take extra care as there is higher risk of infection in that case.

Gastric Leak

In gastric sleeve surgery, 80% of the stomach is removed. This means the surgeon will have to cut away that part of the stomach, and then staple it shut. The staples are then sewn over to ensure the cut is fully closed. However, there is a risk of the cut not being fully closed, thus causing gastric leak.

Ideally, the surgeon will pump air or liquid into the stomach to test the seam. If he or she does not, stomach fluids may leak and damage organs in the body. If your surgery is laparoscopic (through a series of small cuts rather than through one large cut), the risk of gastric leak is higher.

Blood Clot or Thrombosis

Blood clotting automatically happens when you have a cut or abrasion, or basically any time you bleed. It is what clogs the wound so that you will not suffer blood loss. During the surgery, clotting will also happen to slow the blood loss. However, after the surgery is done and the vessels sutured, the blood-flow should be normal.

Because you are most likely going to be immobile after surgery, it is possible for blood clots to develop within the blood vessels. Because there is no bleeding, the clots end up clogging the vessels and stopping blood flow. If you feel pain in your chest that feels like squeezing, or pain and paralysis along your extremities for no reason, see a doctor.

Nutritional Deficiency

Gastric sleeve surgery does not require the reattaching of the stomach lower on the small intestine, as gastric bypass does. The gastric bypass causes less calorie absorption, but simultaneously less nutrient absorption. Gastric sleeve surgery, therefore, is considered a better choice if nutritional deficiency is the danger.

However, there is still some deficiency. A study shows that the nutrient absorption drops for the next 3 months after surgery, perhaps due to trauma. However, after those first 3 months, most nutrient levels go back to normal. Iron in particular may become deficient, requiring supplements. Supplements are also needed for calcium, selenium, Vitamin B12, and others.

Gallstones

4.7% of patients who take gastric sleeve surgery develop complicated gallstone problems afterwards. Obese people, especially if they have diabetes, are at risk of developing gallstones. However, rapid weight loss can also have an impact. The liver makes more cholesterol as the body loses weight, which may cause cholesterol gallstones.

The best thing to do would be to go regularly to the doctor for checkups, and to watch out for any of the symptoms. It may develop over a number of years. Routine blood tests should be enough to tell your physician whether or not you have gallstones.

Heartburn

Heartburn is in itself a symptom of acid reflux. Acid reflux is when some of the stomach’s contents, along with stomach acid, go back up the esophagus. Because the sensation causes a burning in the lower part of the chest, it is often referred to as heartburn. Obesity is one of the causes of acid reflux.

As your body adjusts to the surgery and the lessened stomach space, you may experience heartburn a little more than you are accustomed to. However, as your diet and lifestyle change, the feelings of heartburn will go down. Make certain your doctor knows what you are experiencing, as he or she might prescribe some pills or drugs.

The Best Way to Prevent Gastric Sleeve Complications

Although you can never really do away with the risks of surgery, you can do your part to lessen them as much as you can. In that way, you will have a better chance of an uncomplicated surgery, and of a faster recovery after.

Fully Disclose any Pre-Existing Condition or Allergy

In most cases, you will already have one co-morbidity along with obesity. Most insurance companies and some hospitals only admit patients with at least one obesity-related complication. This can be sleep apnea, Type-2 diabetes, and others.

However, whatever other allergy or sickness you have, disclose it to your physician. Even if the allergy seems as unrelated as possible, such as lactose-intolerance, tell the physician. Remember, if you have one recurrent allergy (a pollen allergy, seasonal allergies), you are more likely to be allergic to other chemicals and allergens.

Follow the Pre-Operation Diet

Especially for weight loss or bariatric surgery, the surgeon will prescribe a pre-operation diet. If it is not followed, your surgery might even be cancelled. The diet is for you to shed as much excess weight as you can before the surgery, so that there is less risk to you. It will also lower the risk of your co-morbidities causing complications.

Most importantly, the pre-operation diet will reduce the size of your liver. Your surgeon has to lift the liver out of the way to get to the stomach. The more enlarged the liver is, the more difficult the surgery will be for the surgeon, and the more dangerous for you.

Gastric Sleeve Surgery: Solution of Last Resort

You might think that gastric sleeve surgery is unreasonably hard to get. After all, if you want weight loss surgery, why can you not just have it? One of the main reasons surgery is reasonably difficult to have is because of the risks involved. No one is trying to make your life harder by recommending diet and exercise.

Gastric sleeve surgery will change your life. However, there are risks involved that you have to know. None of the complications described are 100% sure to happen, but neither can they be a 100% removed. As you consider this kind of life change, balancing the pros and cons of gastric sleeve surgery will help you make the best decision for you.

The Cost of Gastric Sleeve Surgery

January 22, 2016

Over all of the United States, as of 2015, 51.4 million surgeries are done every year. Of those surgeries, only 179,000 surgeries every year are bariatric (weight loss) surgeries. Costs of surgery, of course, differ by state and the competition in that state.

According to Obesity Coverage, $16,800 is the average cost of gastric sleeve surgery across the United States. However, while at first it seems much more practical to go across state for surgery, it might become more expensive in the long run.

How Do Gastric Sleeve Surgery Costs Compare to Gastric Bypass Surgery?

Gastric bypass surgery involves stapling the stomach, leaving a walnut-sized portion, and then attaching the stomach to a lower part of the small intestine. This causes less calorie absorption, and the smaller stomach means you get more full, sooner.

Gastric sleeve surgery was initially considered a safety measure for gastric bypass surgery patients. Because of this, it is usually a cheaper option than gastric bypass surgery. Gastric bypass surgery is $24,000, compared to the almost $17,000 of gastric sleeve surgery.

Why is Gastric Sleeve Surgery in Some States so Much More Expensive than in Others?

It usually depends on the demand for weight loss surgery in the specific state. The higher the demand, the more surgeons will be offering that kind of surgical procedure. The more surgeons there are, the more competition there will be among surgeons. The higher the competition, the lower the prices go.

Looking at the states with the cheapest gastric sleeve surgeries, it is evident they tend to correlate with states with the highest obesity rates. Oklahoma is the cheapest state to get a surgery in ($9,795). It is also 6th in the most obese states in the United States, with a 33.0% obesity rate. Georgia, cheapest after Oklahoma ($11,220), ranks 19th with a 30.5% obesity rate.

Following is a list of the states according to price, with their national obesity ranking and if they have mandatory coverage under Obamacare.

State	Price	Ranking	Insurance Coverage
Oklahoma	$ 9,795	6th – 33.0%	Mandatory coverage by Obamacare
Georgia	$ 11,220	19th – 30.5%	—
Nebraska	$ 11,760	21st – 30.2%	—
Arkansas	$ 11,934	1st – 35.9%	—
Kentucky	$ 12,610	12th – 31.6%	—
Kansas	$13,390	13th – 31.3%	—
Texas	$13,770	11th – 31.9%	—
Indiana	$ 13, 905	7th – 32.7%	—
New Jersey	$14,065	41st – 26.9%	Mandatory coverage by Obamacare
Nevada	$ 14,085	35th – 27.7%	Mandatory coverage by Obamacare
Florida	$ 14,112	44th – 26.2%	—
Utah	$ 14,222	45th – 25.7%	—
Mississippi	$ 14,280	3rd – 35.5%	—
North Carolina	$ 14,685	25th – 29.7%	Mandatory coverage by Obamacare
Colorado	$ 14,700	51st – 21.3%	—
Alabama	$ 14,935	5th – 33.5%	—
California	$ 15,130	47th – 24.7%	Mandatory coverage by Obamacare
Louisiana	$ 15,402	4th – 34.9%	—
Washington DC	$ 16,219	50th – 21.7%	—
Ohio	$ 16,415	8th – 32.6%	—
Tennessee	$ 16, 415	14th – 31.2%	—
South Carolina	$ 16,660	10th – 32.1%	—
Missouri	$ 16,668	20th – 30.2%	—
Wisconsin	$ 17,340	15th – 31.1%	—
Oregon	$ 17,800	34th – 27.9%	—
Virginia	$ 18,360	31st – 28.5%	—
Michigan	$ 18,430	18th – 30.7%	Mandatory coverage by Obamacare
West Virginia	$ 18,430	2nd – 35.7%	Mandatory coverage by Obamacare
Montana	$ 18, 620	42nd – 26.4%	—
Maine	$ 18,624	33rd – 28.2%	Mandatory coverage by Obamacare
North Dakota	$19,580	9th – 32.2%	Mandatory coverage by Obamacare
New Mexico	$ 19,580	32nd – 28.4%	Mandatory coverage by Obamacare
South Dakota	$ 19,580	23rd – 29.8%	Mandatory coverage by Obamacare
Pennsylvania	$ 20,370	22nd – 29.8%	—
Arizona	$ 20,470	29th – 28.9%	Mandatory coverage by Obamacare
New York	$ 20,470	39th – 27.0%	Mandatory coverage by Obamacare
Minnesota	$ 20,580	36th – 27.6%	—
Wyoming	$ 22,250	27th – 29.5%	Mandatory coverage by Obamacare
Idaho	$ 24,920	31st – 28.9%	—
Massachusetts	$ 31,150	48th – 23.3%	Mandatory coverage by Obamacare

The Affordable Care Act, also known as Obamacare, requires some states to make sure their insurance companies pay for weight loss surgery. This Act covers Family Plans, individual insurance plans, and Small Group plans (businesses with less than 50 employees). With more than 50 employees, the employer decides if the insurance plan will cover weight loss surgery.

As the table shows, there are still plenty of states not covered by Obamacare. However, the states on the more expensive side of the spectrum tend to have mandatory Obamacare coverage. Check with your surgeon, and ask if he or she can confirm your insurance coverage. Alternatively, you can ask your human resources department (HR), or check through your insurance policy summary.

Medicare also covers weight loss surgeries as long as a certain level of criteria is met. However, as long as the eligibility requirements are met, you can have lap band surgery, gastric bypass surgery, and gastric sleeve surgery.

When Can You Apply for Gastric Sleeve Surgery?

Insurance companies are the most likely to have strict requirements for those applying to receive gastric sleeve surgery. However, doctors also need to show that their procedure was necessary for the patient. If you are opting for other financial aid, such as loans or special health savings accounts, you usually still need to prove eligibility for surgery.

First, you need a physician-confirmed body mass index (BMI) of 40, which is classified as morbid obesity (BMI 40-44.9). However, there are some cases when there is already an obesity-related condition (a co-morbidity) that causes complications. You will probably need surgery earlier.

In those cases, you can apply at BMI 35 (severe obesity), as long as you have certain conditions (in the next section). With Medicare, you need to have a co-morbidity to be eligible for insurance coverage. You also need to prove you were obese for at least 5 years.

Next, you need to prove, through medical supervision, that you have been on a physician-recommended diet for 3 to 7 months. It depends on your insurance provider and on your physician. Your primary physician needs to give you a medical clearance letter for surgery, which you will submit wherever you are getting funding from.

You will also need clearance and an evaluation from a Registered Dietitian, and a history of other weight-loss treatments. This medical history includes all of the health problems you are facing that are obesity-related, any extra difficulties you are going through as a result of your condition, and any treatment you have gone through. If you have done any other weight-loss treatments before, you need to provide the reason for discontinuing them.

Under Medicare, you also need a psychological evaluation, and several other tests that rule out other causes for obesity. You will need your thyroid, adrenal, and pituitary tests to all register as normal. You also need to prove you have tried, and failed, at least one other weight loss program.

Conditions Which Allow Early Surgery (BMI = 35)

Clinically Significant Obstructive Sleep Apnea

Sleep apnea is a condition in which the patient simply stops breathing while he or she is asleep. Obstructive sleep apnea usually happens with obese patients. The weight of fat on the airway causes a throat tissue collapse. The airway becomes fully blocked, and the patient stops breathing until he or she wakes up from loss of air, or shifts position.

Coronary Heart Disease

The coronary arteries are the arteries which carry oxygen-rich blood to the heart. When there is a buildup of fat along the artery walls, less and less blood, and therefore less and less oxygen, reach the heart. If the arteries become blocked, a heart attack can occur. Breakage of the artery would lead to a blood clot.

Resistant Hypertension

Patients with medical hypertension have uncontrollable blood pressures, even with regular treatment. If, after more than 3 visits and consultations the blood pressure remains uncontrollable, it becomes resistant hypertension. It can be caused by excess of fat and stimulants, and even by sleep apnea and diabetes.

Type-II Diabetes

Your body converts food into blood sugar, or glucose, to burn as energy. Insulin channels that glucose into the cells when you need it, and regulates the levels of sugar in the blood for your safety. With too much sugar to deal with, in obese patients, the insulin can no longer cope even when more is produced. Because of that, sugar can either drop or spike dangerously.

Why Not Just Go Out of State?

Before and after gastric sleeve surgery, you will need to have regular checkups, consultations, and tests. Having your primary surgeon in another state may cause more costs than you plan on. Your pre-op weight loss program will have corresponding consultation fees, as will your physician-guided diet. Your post-op check-ups and consultations with your surgeon will provide even more complications.

Best Exercise Programs After Gastric Sleeve Surgery

January 21, 2016

A weight loss lifestyle does not end with gastric sleeve surgery. In fact, gastric sleeve surgery is the gateway to the weight loss lifestyle. Post-surgery is the start of the lifestyle change. Exercise is a large part of that change. Exercising, other than diet alterations, is the only other activity you can do that will effectively bring down your weight after surgery.

Starting Exercise After Gastric Sleeve Surgery

You can only begin exercise between 3 to 6 weeks after surgery, to give your body time to heal from the surgery. While waiting to begin, focus on your diet. Remember that, for weight maintenance, you need to be burning as many calories as you take in. For weight loss, you need to burn more calories than you take in.

Regulating your diet this early will help you get used to eating smaller, healthier portions throughout the day. Your metabolism will stabilize, and you can work on creating the habit of eating small portions. You need this habit so when you begin to exercise, you will still keep your calorie intake constant (not increasing) while you burn them.

Why Start Exercise After Gastric Sleeve Surgery?

Calorie-counting and diet-watching is not the most cheerful of post-surgery pastimes. Exercise improves the mental state by giving you clear, achievable short-term goals that you can see yourself reaching. This encouragement, accompanied by a sense of physical well-being, helps you set your mind on achieving your weight-loss goals.

Exercise also increases your metabolism speed, which will automatically begin to slow down as you eat less food. Your body thinks you are fasting, so it conserves energy in the fat. As you exercise, your metabolism speeds up, and eats that energy. Even when you are not in physical activities, your calorie-burn will speed up.

How To Prepare For Exercise Programs

First, do not aim to run a 10-kilometer marathon within the year. It is an ambitious goal, but you might start too intense and burn out quickly. Even worse, you might injure yourself, and the injury will definitely set your progress back. Instead, aim for consistent, increasingly difficult exercises. Set attainable goals per month, and work consistently at them. If you try to go too fast too soon, you might make less progress than you expect, and become discouraged.

Which Exercise Programs Do I Start With?

Walking

Believe it or not, walking is the best place you can start. For weight maintenance, even normal-weight people walk an hour a day while eating their regular amount of calories. About 3 weeks after surgery, you can begin very light walks. Begin with 20 to 30 minute walks a day, on flat surfaces (no slopes or stairs just yet).

To make it easier to do, especially if 20 minutes seems daunting, break the session into two. Take a 10-minute walk in the morning, and then another 10-minute walk in the afternoon or evening. Walking quickens your metabolism for faster calorie burn. Cardiovascular problems are reduced by 31%, and improves length of life by 32%.

As you get used to the rhythm and habit of the 30-minute walk, increase the difficulty of the walks. For example, instead of walking along a flat surface for 10 minutes, walk up a slight slope, or put some stairs into the mix. If you have been walking in the park, find a route that will take you slightly uphill. This will prepare you for harder exercises.

As you get used to these harder walks, increase the duration slowly. Walk 15 minutes each time instead of 10, and try to reach an hour every day. Even if you split the walks, at least aim for that hour. You are forming the habit of exercise, and also developing mental toughness. Push yourself to reach your attainable goals for each week.

Trampoline-Marching

After you have reached the one-hour mark in walking, you need to start developing core strength, and balance. To do the other exercises you need, you have to start with those. Improving core strength is one of the most important.

The classic example of strength-building is an arm lifting weights. The classic symbol for “strength” is a flexed bicep. However, most professional athletes actually have more core strength than anything else. Core muscles are composed of every muscle group, except those in the arms and legs. The most obvious of the core muscles are found in the belly.

Core strength improves overall body strength and coordination. With a strong core, your arms and legs will move more efficiently. You will also have more balance, and find yourself with more endurance and stamina.

One effective way to build core strength in a non-dangerous way is through marching–not jumping, not bouncing–on a mini-trampoline with a built-in support bar. The natural springiness of the trampoline causes you to adjust and balance, but without stress and too much pain or pressure on your joints.

Begin, like when you started walking, with 20 to 30 minutes of marching a day, 10 minutes per session. Start slowly, for habit- and strength-building. Slowly increase duration, and continue regularly to keep up your progress.

Stationary Bike

The stationary bike graduates you from simple marching and walking. With the stationary bike, you increase the intensity of your use of leg muscle groups. You are required to exert more overall effort than when walking or using the mini-trampoline. Start with the easier settings, and then slowly adjust them to make pedaling harder.

The best part about the stationary bike is that it does not put too much pressure on the joints. While you are exercising the muscle groups, your joints will have a chance to stretch and release. Since people under weight loss programs are usually very heavy, vigorous or intense activity may harm their joints. This would badly set back the patient’s therapy.

Begin the stationary bike at the easiest setting, and within your 10-minute time frame. As the muscles strengthen and weight is lost, you will be able to increase the time of exercising and the difficulty of the biking.

Swimming

Swimming is, bar none, one of the best post-op surgery exercises you can do. If you feel confident enough, you can begin swimming at the same time you begin the first rounds of walking. Swimming places no pressure on the joints, exercises the whole body, and is actually quite easy because fat makes it easier for you to float.

Swimming is associated with a release of stress and tension, which acts as encouragement for habit-forming exercises. A Speedo survey says 70% of swimmers are refreshed in mind after a swim, 74% feel lighter and more relaxed, and 68% experience an increase in self-esteem. All those are needed for encouragement to continue with exercises.

The best part about swimming is that it is 44 times more intensive than walking, because you are moving through water and not air. However, your buoyancy in the water means you only rely on 10% of your weight at a given time. You are working harder, but feeling your weight much less. You also are less at risk of overheating or fainting during exercise.

Warning: Joint Pain Does Not Mean Better Intensity

Do not focus on building on intensity, but on stamina and long-lasting strength and endurance. Because of this, joint pain is not a signal that you are doing well. Some people, who constantly want to push their limits, try to work out and then just stick it out through the pain. However, they face another danger: over-training and possible long-term injury.

As you begin to exercise, and to increase your exercises, expect the normal aches and pains to begin to appear. Especially with walking, using the mini-trampoline, or cycling on the stationary bike, your leg muscles will probably ache. However, you should not feel aches at the ankle, knee, or hip. Joint pain means you are putting too much pressure on the joint.

The moment you feel pain, stop the exercise. Take note of your own time limits. If you began walking at 10 minutes a session, and then decided to increase it to 15, stop if you feel pain at 13 minutes. If you establish that your best session duration at the moment is 12 minutes, then reduce the session to 12 minutes. The build-up is slow, but the more you take care of yourself, the less likely you are to injure yourself and relapse because you had to stop to recover.

The Key to the Best Exercise Program: Form the Habit

You can have the best running shoes money can buy, and still walk irregularly. You can have the best swimsuit you can find, and still swim irregularly. You can have a mini-trampoline in every room, and still march irregularly. If you do not form the steady habit of exercise, you will end up excusing yourself from it every day.

Start slow, with short and attainable goals. You need to get used to the feeling of a walk every day, making it part of daily life. Make a checklist of goals, and post them up somewhere. After you increase a session time, or increase session intensity, check it on the checklist. That way, you can see your progress. Stay encouraged–exercise is effective, so just give it time.