Archive for 'surgery patients'

Weight Loss Surgery

Monday, October 17th, 2011 at 9:59 pm  
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When you are ready to leave the hospital, you may receive a visit from the hospital dietitian who will go over the required diet for Lap-Band patients. It’s important to fully understand the Lap-Band diet before you decide on this type of weight loss surgery. The first 3 to 4 days following Adjustable Gastric Lap-Band surgery patients must follow a clear liquid diet. Failure to follow the prescribed diet can cause complications such as band erosion or slippage that require additional surgery.

If you are a regular coffee, tea, or soda drinker you should be aware that no caffeine is permitted for the first three months after surgery. Carbonated beverages; both diet and regular may cause gas, bloating, and an increase in stomach size due to the carbonation and are not recommended at any time for Lap-Band patients.

The second phase of the Lap-Band diet consists of 5 to 6 weeks of a modified full liquid diet; the key component of this phase is consuming two ounces of a protein shake every hour for ten to twelve hours a day with two ounces of other liquids such as soup, baby food, or sugar-free gelatin three times a day.

During the second six weeks following Lap-Band surgery patients may eat food that is shredded in a food processor prior to eating. The basic foods on the Lap-Band diet include meats or other forms of protein, vegetables, and salads. The Lap-Band diet does not include most bread, potatoes and other starchy vegetables. The length of these phases may be altered according a patient’s personal weight and weight loss goals – my first phase is five weeks, followed by a two week second phase.

Protein is especially important following Lap-Band surgery. After Lap-Band surgery the stomach will never hold more than 4 to 6 ounces per meal, so making every bite count is essential for healthy and nutritionally rounded weight loss success.

Lap-Band patients are advised to consume fifty to sixty grams of protein daily to avoid protein deficiency. Protein deficiency causes hair loss, fatigue, edema, muscle weakness, and a delay in wound healing. A lack of adequate protein may also lead to depression, anxiety, irritability, apathy, and other mental health conditions, as well as cause a number of physical health issues from gallstones to colds, headaches, low blood pressure, anemia, irregular hear rates, and, in extreme cases, death. A lab can measure the amount of protein in your blood by performing a serum albumin blood test.

Eating after Adjustable Gastric Lap-Band surgery means taking tiny bites, and eating very slowly. You should think of your new stomach as a “baby” stomach. You’ll be drinking protein shakes and relearning eating skills much the same way as a new baby eats formula (or breast milk), and slowly adds new foods from blended baby foods to chunkier baby foods.

Certain foods may never be well tolerated by Lap-Band patients. These foods include:

Any medicine you take may need to be adjusted following Lap-Band surgery since you will not be able to swallow pills that are aspirin-size or larger, or capsules or irregular-shaped pills. For me this has meant breaking a blood pressure pill in half, changing my tri-estrogen capsules to a cream form, and taking liquid antibiotics and painkillers for an unrelated infection.

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Tags: Bariatric surgery, irregular-shaped pills, mental health conditions, Weight loss, personal weight

What is the treatment for gall

Sunday, October 16th, 2011 at 5:05 pm  
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Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. (Asymptomatic gallstones usually do not need treatment.) Each year more than 500,000 Americans have gallbladder surgery. The surgery is called cholecystectomy.

The standard surgery is called laparoscopic cholecystectomy. For this operation, the surgeon makes several tiny incisions in the abdomen and inserts surgical instruments and a miniature video camera into the abdomen. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a closeup view of the organs and tissues. While watching the monitor, the surgeon uses the instruments to carefully separate the gallbladder from the liver, ducts, and other structures. Then the cystic duct is cut and the gallbladder removed through one of the small incisions.

Because the abdominal muscles are not cut during laparoscopic surgery, patients have less pain and fewer complications than they would have had after surgery using a large incision across the abdomen. Recovery usually involves only one night in the hospital, followed by several days of restricted activity at home.

If the surgeon discovers any obstacles to the laparoscopic procedure, such as infection or scarring from other operations, the operating team may have to switch to open surgery. In some cases the obstacles are known before surgery, and an open surgery is planned. It is called “open” surgery because the surgeon has to make a 5- to 8-inch incision in the abdomen to remove the gallbladder. This is a major surgery and may require about a 2- to 7-day stay in the hospital and several more weeks at home to recover. Open surgery is required in about 5 percent of gallbladder operations.

The most common complication in gallbladder surgery is injury to the bile ducts. An injured common bile duct can leak bile and cause a painful and potentially dangerous infection. Mild injuries can sometimes be treated nonsurgically. Major injury, however, is more serious and requires additional surgery.

If gallstones are in the bile ducts, the surgeon may use ERCP in removing them before or during the gallbladder surgery. Once the endoscope is in the small intestine, the surgeon locates the affected bile duct. An instrument on the endoscope is used to cut the duct, and the stone is captured in a tiny basket and removed with the endoscope. This two-step procedure is called ERCP with endoscopic sphincterotomy.

Occasionally, a person who has had a cholecystectomy is diagnosed with a gallstone in the bile ducts weeks, months, or even years after the surgery. The two-step ERCP procedure is usually successful in removing the stone.

Nonsurgical approaches are used only in special situations such as when a patient’s condition prevents using an anesthetic and only for cholesterol stones. Stones recur after nonsurgical treatment about half the time. Oral dissolution therapy. Drugs made from bile acid are used to dissolve the stones. The drugs, ursodiol (Actigall) and chenodiol (Chenix), work best for small cholesterol stones. Months or years of treatment may be necessary before all the stones dissolve. Both drugs cause mild diarrhea, and chenodiol may temporarily raise levels of blood cholesterol and the liver enzyme transaminase. Contact dissolution therapy. This experimental procedure involves injecting a drug directly into the gallbladder to dissolve stones. The drug methyl tert butyl can dissolve some stones in 1 to 3 days, but it must be used very carefully because it is a flammable anesthetic that can be toxic. The procedure is being tested in patients with symptomatic, noncalcified cholesterol stones. Extracorporeal shockwave lithotripsy (ESWL). This treatment uses shock waves to break up stones into tiny pieces that can pass through the bile ducts without causing blockages. Attacks of biliary colic (intense pain) are common after treatment, and ESWL’s success rate is not very high. Remaining stones can sometimes be dissolved with medication.

Overview | Causes | Risks | Symptoms | Diagnosis | Treatment | Gallbladder Function | Tips

Reprinted from the National Digestive Diseases Information Clearinghouse (NDDIC)

More About Gall Bladders

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Tags: bile ducts, common complication, miniature video camera, liver enzyme transaminase, Gallbladder Function

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