Community Forum

Insurance

2009-10-01T20:30:46Z

My insurancde only covers 3 adjustments, what if my husband or daughter needs additional adjustments? what is the charge?

Getting down

2009-08-22T10:12:11Z

I am stuck again at a plateau and it is wearing on me emotionally. Anyone have any suggestions?
Thanks, Kathy

Support Group in Salina and Hutchinson areas

2010-08-20T07:39:07Z

I have several patients asking to get support groups in the Salina and Hutchinson areas. If you live close to one of these areas and are interested, please email me at lmiller at moreoflife dot com.

August Support Group meetings

2010-08-10T08:46:34Z

Reminder: Support group at 7 PM, August 12 at Genesis and August 17 at 1 PM in office. We will be starting our motivational challenge this month. Please bring a few goals that you wish to accomplish during the next several months as we will be documenting them at the meeting. The rules for the challenge are listed below. See you there. Lou
Motivational challenge rules for support group attendees.
The challenge will run from the August through December meetings.
Prizes will be determined later.
Rules:
1. Weight, measurements, and pictures will be taken at the August meeting and compared with the same taken at the December meeting. Weight will be tracked at the monthly meetings.
2. Attendance is expected at one support group meeting every month. A maximum of one missed meeting will be allowed.
3. Individual goals will be set up at the August meeting and given to Lou. This is very important as this challenge is based more on changes in lifestyle and motivation than actual changes in weight and measurements.

May 2010 Newsletter, Focus on Vitamins

2010-04-15T16:16:38Z

Focus on Vitamins:
About Vitamin B12 and B12 Deficiency
What does vitamin B12 do?
Vitamin B12 is one of the B-complex vitamins. It is important for the function of your nerves and for the production of the DNA and RNA in your cells. It also works together with folic acid to make red blood cells and other compounds that are important for your cardiovascular and immune systems.
What happens if my B12 is low/if I don’t get enough B12?
If you do not have enough B12 you may notice that you become fatigued easily and feel tired and weak. You may experience dizziness, heart palpitations (rapid heartbeats), and feel short of breath. Other common symptoms are poor appetite, sore/swollen tongue, and numbness and tingling of the hands and feet.
It is common for people with low B12 to develop anemia because they can’t make blood cells normally. With this anemia, cells become large and the nucleus of the cell is not formed properly. If B12 deficiency is allowed to continue for a long time, serious problems can develop such as permanent damage to the nerves, memory loss and dementia.
What are other symptoms?
• Diarrhea
• Yellowish skin and eyes
• Irritability and depression
• Psychosis
• Muscle weakness, difficulty walking
• Changes in vision
• Burning sensation around mouth

Where can I get B12?
B12 is only found in foods of animal origins. Plants do not make B12 – so fruits, vegetables, beans and grains will not supply this vitamin. Good dietary sources of vitamin B12 include fish, dairy products, organ meats (particularly liver and kidney), eggs, beef, and pork. You can also get B12 in dietary supplements. It is found in most multivitamins, in B-complex, and alone in tablets, capsules, liquids and sublinguals (pills that dissolve under the tongue). It is also available as a prescription as injections or as a nasal spray. If you have B12 deficiency, your doctor will probably ask you to take supplemental or prescription B12 and watch your dietary intake.
Other important things
If you have weight loss surgery such as gastric bypass, it is harder for the body to absorb B12 from food and from some types of supplements. For this reason, your doctor may ask you to use a sublingual product, or to get regular injections to prevent problems. If you have B12 deficiency, it is important that you follow up with your doctor for lab tests and other recommended care.

August Newsletter, Part 4

2010-07-20T13:31:57Z

Focus on Vitamins and Minerals
Zinc
Zinc is an essential trace mineral with many functions in the body. Some of these functions include digestions, cellular respiration, immune function, and antioxidant activity. Zinc is used by virtually every type of tissue in the body. The eyes, heart, adrenal glands, lungs, brain, skin, and prostate (in men) all store zinc. Adults store 2 to 3 grams of zinc but unlike most other minerals, zinc form tissues cannot be readily mobilized to compensate for low dietary intake. Dietary factors can significantly impair or assist absorption of zinc. Zinc is found in most animal proteins, including egg yolks and dairy products. These tend to be the best sources of zinc as it better absorbed in the presence of protein. Other substantial sources of zinc include nuts, seeds, and whole grains. However, the fiber in grains may impair absorption and refined grains have very little zinc in them.
Deficiency:
Zinc deficiency is not well understood. Deficiencies have been found with malabsorption, eating disorders, Crohn’s disease, and Celiac disease. Serious injury, illness, stress, burns, and surgery increase zinc utilization and may contribute to deficiency. Signs of zinc deficiency can include symptoms such as: loss of smell, abnormal or diminished sense of taste, photophobia, loss of night vision, poor wound healing, skin rashes or rough skin, hair loss/thinning hair, poor appetite, tiredness, grooved or deformed nails, decreased libido in men, canker sores, crusting around the mouth, rash in and around the mouth that can look like thrush (yeast), lip fissures, and more frequent infections.
Treatment:
The recommended daily amount of zinc is 15 mg for men and 12 mg for women. Most multivitamin/mineral formulas have this amount so if you are eating right and taking a good multivitamin/mineral you are probably getting enough zinc for body needs. For mild deficiency, doses of 15 to 30 milligrams per day taken between meals and away from other minerals (iron or copper) should be tried. In more severe deficiency higher doses are needed and should be discussed and monitored by either your primary care provider or gastric band provider or both. If digestive upset occurs and is persistent, zinc can be taken with protein food or protein drink.
Zinc excess or Toxicity:
Therapeutic zinc levels can overlap with toxicity so it is important to know what can occur. Acute toxicity of zinc most commonly presents with gastrointestinal upset. The most common symptoms are abdominal pain, diarrhea, nausea, vomiting, and metallic taste in the mouth. This can happen at doses as low as 30 milligrams.

August Newsletter, Part 3

2010-07-20T13:30:36Z

Chellie’s “Have it Your Way” Ratatouille by Chellie H., OH Member Services Team

This is a great recipe for any season, but as eggplant and zucchini are easily available in the summer, it is a summer favorite for me. I love making a huge double or triple batch of veggies and adding meat or seafood to the veggie leftovers… it’s like having a new meal every time I open the fridge. It works great as a main meal with the meat mixed in, or using the veggies alone as an awesome side dish. The versatility of this dish is a crowd pleaser in my family.

Serves 4
Ingredients:
1 teaspoon olive oil
1 large chopped onion, roughly chopped
3 cloves garlic, thinly sliced
1 pound of zucchini, diced into 1/2-inch
1 large eggplant, unpeeled, diced into 1/2-inch
1/2 red bell pepper, diced into 1/2-inch
1/2 green bell pepper, diced into 1/2-inch (I like to use orange bell peppers for color)
1/2 yellow bell pepper, diced into 1/2-inch
1 pound of fresh tomatoes, skinned and chopped (or one 14.5-oz can diced tomatoes)
1-1/2 teaspoons salt
1/4 teaspoon black pepper
1/8 teaspoon red pepper flakes (use red pepper flakes if you want it spicy)
4 sprigs of thyme (optional)
1 sprig of rosemary (optional)
2 pounds of your favorite protein (optional)
Directions:
1. Preheat oven to 400°F. Using a large oven-proof pan over medium-high heat, sauté onions in olive oil until they begin to soften. (About 5 minutes.) Add garlic and reduce heat to low.
2. While the onions and garlic are cooking over low heat, put 2 tablespoons of olive oil in another large skillet over high heat. As soon as the pan gets hot, add enough zucchini cubes to form a layer on the bottom of the pan. Cook over high heat; stir until zucchini is lightly browned on all sides. Remove zucchini cubes, and add them to pan with the onions.
3. Repeat process until all of the zucchini cubes have been cooked. Continue with the bell peppers, then the eggplant cubes, adding the browned vegetables to the onion pan as soon as they are cooked. Add more olive oil as needed.
4. Add the tomatoes (and their juice) to your large oven-proof pan with the rest of the vegetables, along with salt, black pepper, red pepper, thyme, rosemary and 1/4 cup of water. Bring to a boil.
5. Brown 2 pounds of your favorite protein in skillet, drain and mix in pan with vegetables.
6. Transfer to the oven and cook, for 30-40 minutes, until the mixture is cooked through and flavors are melded together.
Notes:
a. You can substitute any lean protein you like or enjoy it with the vegetables only. The nutritional information below is listed for some options.
b. The fat per-serving can be cut down by reducing the amount of olive oil or substituting cooking spray.
Nutritional Information per Serving:
Veggies Only Ground Meat - 95 percent lean meat Sausage Shrimp Scallops
Calories 62 148 300 163 120
Total Fat 3 5 22 3 4
Carbs 8 0 0 1.4 3
Protein 1 23 20 32 18
Dietary Fiber 3 0 0 0 0

Chicken and Spinach Salad
Makes 4 servings
12 ounces chicken tenders
nonstick cooking spray
4 cups washed, stemmed and shredded spinach
2 cups washed and torn romaine lettuce
8 thin slices red onion, separated into rings
2 tablespoons (1/2 ounce) crumbled blue cheese
1 large grapefruit, peeled and sectioned
½ cup frozen citrus blend concentrate, thawed
¼ cup prepared fat-free Italian salad dressing
Cut chicken into 2 X ½ inc strips. Spray large nonstick skillet with cooking spray; heat over medium heat until hot. Add chicken; cook and stir 5 minutes or until no longer pink in the center. Remove from skillet; set aside.
Divide spinach, lettuce onion, cheese, grapefruit and chicken among 4 salad plates. Combine citrus blend concentrate and Italian dressing in small bowl; drizzle over salads.
Nutrients per serving:
Calories: 218, Calories from Fat: 15%, total fat: 4 gms, saturated fat: 1 gm., cholesterol: 55 mg, Sodium: 361 mg, carbohydrate: 23 gms, fiber: 3 gms, protein: 23 gms. Dietary exchanges: 1 fruit, 2 vegetable, 2 meat

August Newsletter, Part 2

2010-07-20T13:24:28Z

Healthy Eating and Diet: Thoughts from Dr. Phil’s Ultimate Weight Solution, Taken from book review posted on WebMD
Dr. Phil outlines seven key points to understanding and facing your “personal truth” - how you view yourself and your weight. Then you must replace these toxic messages with positive thoughts, says Dr. Phil.
“It’s about changing yourself from the inside out, so that being fit and healthy for you is as natural and as normal as breathing,” he writes. “By changing yourself from the inside out, you will be able to attain and permanently maintain what I call your get-real weight—- the weight that is healthy and realistic for your age and your physical and genetic makeup, a weight at which you are happy and truly at peace with your size, and a weight that is stable because you have taken control of every factor in your life that keeps it there.”
Programming yourself for success is the key. “Programming involves making small, deliberate modifications in the way you live your life, and it has everything to do with developing a lifestyle that creates healthier behavior,” he explains.
The seven steps to weight loss freedom:
1. Right Thinking: Get rid of self-defeating thought patterns, believe that you will succeed, and you will have mastered the first key necessary to overcoming your struggles with your weight.
2. Healing Feelings: Make choices that stop the cycle of emotional eating that has perpetuated your weight problem. Don’t let stress, anxiety, or depression lead you to self-medicate with food. Change your emotional response to life’s problems, and the unwanted eating behaviors that flow from it, and you can change. He instructs readers in how to identify the “payoff” you get from overeating and addressing those negative feelings—getting emotional closure, so you stop self-defeating habits, says Dr. Phil.
3. A No-Fail Environment: You must program your environment in every possible way to avoid binge foods and reminders to eat.
4. Mastery Over Food and Impulse Eating: “Did you binge or overeat for one reason, such as a betrayal, a job loss, an illness, some personal tragedy, and you’ve kept on doing it as a matter of habit? Your pounds came on quickly, but the trouble is, they stayed because you are overeating habitually, whether you are hungry or not,” writes Dr. Phil.
5. High-Response Cost, High-Yield Foods: This is Dr. Phil’s way of saying, “eat high-fiber and other nutritious and filling foods - whole grains, lean protein, fresh fruits and vegetables, dried beans.” It also implies eating foods that take time and effort to fix, require lots of chewing, and aren’t fast food or other convenience foods.
6. Intentional Exercise: “Regular, intentional exercise is a big deal, a huge deal,” writes Dr. Phil. “It unlocks the door to body control - a state of fitness in which your body is metabolically geared for losing weight and keeping it off, and is flowing with energy and vitality People who successfully manage their weight and stay fit exercise as a matter of habit.”
7. Your Circle of Support: “Weight loss is not a do-it-yourself deal,” he writes. “If you expect to lose weight and keep it off, you must build and nurture relationships that affirm and uplift you in life-changing ways. There is strength and power in support.”

August Newsletter, Part 1

2010-07-20T13:21:52Z

Banded Together Wichita Newsletter August 2010
Support Group:
August 12: Genesis Health Club, 854 N. Socora, Wichita at 7 PM.
Topic: Motivational challenge rules.

August 17: 1 PM in the office.

July winners: Karen and Robert won gift cards. Belinda, Sondra, and Jill won rewards points.
New Opportunity
“Motivational challenge.” Starts in August and goes through December. Must attend August Support Group for details.
Things to think about:

What is your definition of weight loss surgery success? Now that you have had weight loss surgery and become healthier, you need to take your eyes off the scale and focus on Non-Scale Victories (NSV).

A non-scale victory is an ability, situation or observance that reflects how your health, fitness and overall life have improved. It is an accomplishment or something that you can do now (or have done) since having surgery and losing weight. It is any success that you enjoy in your life outside of your total body weight numbers.
Here are some NSV’s to think about in your life.
1. Change in numbers: change in body fat percentage, muscle mass, blood pressure, values in your lab tests.
2. Clothes: how your clothes fit now compared to before surgery, where do you buy your clothes now compared to before surgery.
3. Medications: has there been a change in the dosage of your meds or discontinuance of some meds you were taking prior to surgery.
4. Energy: do you have more energy, vitality, and a new zest for life? Does your energy last throughout the day?
5. Room to spare: do you have more room between you and the steering wheel, able to fit comfortably in an airplane seat without a seatbelt extension, or sit in a booth at a restaurant rather than a table?
6. Tie and cross: can you tie your shoes and cross your legs?
7. New “Tude”: do you have a new attitude toward life and activities in your life?
8. Fingers, eyes and toes: are you wearing a smaller shoe size, had your rings re-sized, or your glasses adjusted to fit your smaller face?
9. New bones: are you feeling and seeing new bones that you have not seen or felt for years or at all in the past?
10. Face your face: Compare a picture prior to surgery to the one you see in the mirror now.
11. It’s the little and big things: Take notice of the many small and large NSV’s that occur all the time. Some of the most profound are the changes in choices and behavior.
12. Overall daily well-being: Some of the best NSV’s are increased confidence and higher self-esteem; also determination and persistence; feeling more comfortable within yourself which projects outwardly to others. The best NSV of all is your enhanced quality of life.
A great way to outlast a plateau showing up on the scale is to make a list of all your NSV’s. When you review your list it can provide encouragement to outlast any pesky plateau. Small Bite of inspiration: taken from Small Bites Daily Inspirations for weight Loss Surgery Patients by Katie Jay and Julia A. F. Persing
Stand up.
Standing up for yourself and being who you are can be very hard. But you do not have to give into the pressures of life. You can remain true to yourself. Yes, it is often easier to fall into line with the rest of society. But the long-term results can be devastating, especially when it comes to food. So many temptations exist that are unhealthy; you just can’t afford to indulge all the time.
Do you want to be a mindless automaton in the machine of life? Or do you want to take control of that machine? After WLS, following in the way of the world can mean disaster. Shaping your new reality to meet your needs will lead to success.
Action for the day
Walk your own path today. The one that will lead you to the great health and well-being for which you have longed.
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Something you may be interested in: As I have discussed at office visits and support group meetings, it is helpful to food journal periodically to see actually what and how much you are eating, especially if you are struggling with portion control. Here are some new sources for those of you who may want check them out.

Losing Weight the Smartphone Way, With a Nutritionist in Your Pocket (July 17, 2010) LOSEIT (iPod Touch, iPad and iPhone; free).
Tell the app how much weight you want to lose and how many pounds per week you want to take off, and it calculates the amount of calories you can consume each day. LoseIt has a database of 40,000 food items and can also calculate how many calories your daily exercise burns up.

CALORIE COUNTER by FatSecret (works on all platforms; free).
This program works much like LoseIt. But one advantage is that when you enter your basic information, you can sync up with the FatSecret Web site. The site has forums where users can swap ideas about diets, recipes and working out.

TAP & TRACK (iPhone, iPod Touch and iPad; $3.99).
This app costs $4, but users say it’s worth every penny. The program helps you come up with a daily calorie goal and features a large food and exercise database.

WEIGHT WATCHERS MOBILE (iPhone, iPod Touch and iPad, BlackBerry and Windows Mobile 6; subscription required).
If you already follow Weight Watchers or Weight Watchers Online, consider their app or one that can track the points used in their diets. Free for online subscribers, Weight Watchers Mobile lets you track and calculate points and see your weight loss history.

support group attendance

2010-07-14T20:54:06Z

I want to know why attendance at support group has dropped—-we used to have a room full now only a few—if it is the change in days—maybe we should change back—-I need more support—I am very needy (LOL) I also miss many people who used to come!! talk to me people