According on one's courage, life can either get smaller or bigger.
The Diary of Anais Nin by Anais Nin
Patients always mention their operation day with tremendous anticipation. It truly is a significant occasion that ushers in a new stage of life. To help assure your safety, there are a few issues that need to be resolved before entering the operation room. These specifics are discussed in this chapter along with their significance. A sense of healthy expectation and some worries might be eased by knowing what to expect clearly.
Procedure Testing
Before being referred for weight-loss surgery, many patients have previously undergone a complete medical evaluation by their primary care physician. Patients with recognized medical conditions like diabetes, hypertension, and heart disease are particularly at risk in this regard. However, some basic lab tests may be required for individuals who haven't visited their personal doctor in a while to find out their current state of health. Likewise, additional testing can be necessary before performing AGB surgery if inquiries or worries about particular medical conditions crop up during the screening process. The outcomes of these tests may in certain cases even indicate whether the AGB is a viable weight-loss solution.
The condition of your heart and pulmonary functions is obviously crucial because the procedure necessitates general anesthesia, which means you will be fully unconscious and under the supervision of the anesthesiologist. Most patients' medical histories and physical exams make it quite simple to determine this.
examination. However, a more thorough evaluation of particular organs may be required for persons who have a history of serious medical issues.
An assessment of pulmonary function may be advised if there is a history of persistent respiratory issues. Patients with poor lung health are more at risk during anesthesia, especially those who need oxygen even when at rest. In order to improve the patient's breathing during surgery, the anesthesiologist may ask that a pulmonologist, or lung expert, be called in beforehand.
The relative risk of a cardiac complication during or after surgery may also need to be evaluated in individuals with a history of heart issues by a cardiologist. An ECG or, in some situations, a cardiac stress test may be used to determine how the heart would likely react to the demands of surgery.
Diabetes patients should keep their blood sugar under tolerable control before surgery, especially right before and right after the procedure. Numerous factors, such as the preoperative diet, the lack of meals on the day of the procedure, intravenous fluids and drugs, as well as the stress of surgery, can cause considerable changes in blood glucose levels. It is extremely simple to test the blood sugar often throughout these intervals, and doing so gives valuable information for keeping a safe operative path.
A thorough panel of blood tests will give patients with a history of liver or kidney illness a clearer view of the condition of those important organs' functional status. Without seeing a specialist, performing surgery may not be advised if either organ system has been compromised significantly. A nephrologist would be the expert for kidney function issues, and a gastroenterologist or hepatologist for aberrant liver function. Surgery to implant the AGB may or may not be a viable option, depending on the severity of the issue and whether it has a recent or more enduring beginning.
Sleep apnea is one of the most prevalent comorbidities that go along with obesity. In certain instances, this could be the main justification a patient gives for wanting weight-loss surgery. Numerous people lament their chronic weariness, heavy snoring, or sleeping issues. These problems are frequently caused by sleep apnea, but the majority of individuals who experience them have not had a formal sleep study. Those who have are typically using CPAP or BiPAP at night as an airway support. To enhance their airways, some people have even had one or more surgical procedures.
While a sleep study can show that sleep apnea exists, it is unclear whether making the diagnosis this way will alter the process. Weight loss is the only effective treatment for sleep apnea, hence the AGB surgery's main goal is weight loss. Sleep tests can be expensive, and whether the test is positive or negative, the chosen course of action is unlikely to change. Prior to surgery, getting a sleep study is typically done primarily to document the issue in an effort to meet insurance requirements for the procedure. An overnight sleep study is the best test to do if documentation of sleep apnea is required for any reason. The test is best carried out in a sleep laboratory that has sophisticated monitoring apparatus. It can also be done at home, however monitoring options are typically more constrained.
Each of these preoperative tests can help you feel more at ease, but they cannot absolutely prevent significant issues. Even someone who has never had any medical issues before could experience complications during surgery. It is frequently questioned whether every patient needs to go through a rigorous battery of exams before undergoing any kind of surgery. There is currently no proof, nevertheless, that such a strategy would appreciably alter the course of treatment for the majority of patients. An skilled surgeon and anesthesiologist, as well as an operating crew that is knowledgeable about the process and sensitive to the specifics of your care, are the most crucial variables in lowering the risks of surgery.
Preoperative Diet
Once a patient is determined to be an appropriate candidate for the AGB, some specialists are willing to perform surgery right away. While it is normally possible to carry out the treatment properly, this method runs the danger of running into circumstances that could make the surgery much more challenging than it needs to be. Patients who are severely obese almost invariably have considerable glycogen stores in their livers. It can be challenging to expose the liver and carry out the necessary dissection around the upper part of the stomach in obese patients since their livers are frequently rather massive and heavy. To make band surgery safer, the pre-op diet is intended to make the liver smaller and lighter.
Diet to Reduce Liver Size Before Surgery
provided by the Texas-based MASTER CENTER® for Minimally Invasive Surgery, LLP
Nutrition Plan for Three Weeks
Prior to AGB surgery, the liver's size should be reduced.
Breakfast: 2 scoops of a high-protein beverage (300 calories and 48 grams of protein).
Check out "Recipes for Protein Shakes" on pages 144–145.
Lunch: Two scoops of a high-protein beverage supplement
(48g of protein and 300 calories)
Check out "Recipes for Protein Shakes" on pages 144–145.
Dinner: 4 oz. cooked (28 grams of protein) grilled, roasted, or broiled chicken, fish, or turkey
Green beans, carrots, broccoli, celery, spinach, beets, tomatoes, cauliflower, brussels sprouts, turnip greens, asparagus, zucchini squash, yellow squash, cabbage, cucumbers, radishes, eggplant, or okra (boiled) are some examples of low-calorie vegetables that are available in two cups.
Lettuce, tomato, and a fat-free salad dressing.
I cup of fresh fruit
A 400 calorie diet
(200 calories) Snack
See the page 146 list of protein snacks.
By putting the patient on a pre-operative diet intended to use up the glycogen stored in the liver, thereby reducing it and making it easier to move out of the way during surgery, the size of the fatty liver can be greatly reduced. Each patient in my office receives a low-fat, low-carbohydrate diet for three weeks before to surgery from our dietitian. Two meals a day on the diet consist of a protein smoothie. The third meal includes vegetables without additional fat, like butter or margarine, along with broiled or grilled fish, chicken, or turkey.
Almost anyone can follow this diet for the full three weeks as long as they comprehend the goals. Patients typically drop 8 to 10 pounds during this time, giving them a strong head start on their regimen.
The Rational Belief Tests
psychologist G. Dick Miller
As I've already stated, the best method to modify your thinking is to question your present ideas. You can use these five tests to determine if you have an eating disorder after writing down your thoughts on food and what you are consuming.
You are telling yourself sensible things. These ideas have existed for a long time. You'll be on the right track to making the improvements you want to see in your weight if you use these guidelines to analyze your thinking and swap out false beliefs with ones that are consistent with these concepts.
Is it literally true? is the first simple test. In other words, could I convince a third party to accept my argument? My daughter is an attorney, and I frequently testify in court as an expert witness. I occasionally tell her that I am worried about a particular case and that I'm not sure I'm as ready as I should be. She instructs, "Just get up there, tell them the facts, and shut up." This is a guideline to follow when speaking to oneself, not simply a jury.
The second gauge: Is it beneficial to my bodily well-being? Many people frequently find ways to justify beliefs and acts that are harmful to their bodily well-being. We discuss the poisons we expose our bodies to frequently. It was not necessary for our grandparents to make this choice. There were no preservatives, junk food, or stores on wheels, they only ate what they could grow, and the quantity was little. "So everybody drinks," or "What is one cookie going to matter?" are common phrases I hear.
The truth is that nobody has bad eating habits, as we discover when we study such ideas. I'll give you that the culture we live in contributes to the fact that more of us have poor habits. But we do pay for our decisions. Do you really want to be one of the people who does it while everyone else doesn't?
The final test is: Do my current thoughts align with my short- and long-term objectives? When I ask students to write about their inner dialogue in their homework assignments, I believe the situation becomes evident. It is obvious that we sacrifice our long-term objectives in favor of our short-term objectives. When asked if they desire to be healthy as they age, most people will respond in the affirmative. But we aren't making decisions that are good for both our short-term and long-term objectives because to Madison Avenue and our history of irrational thinking. I frequently tell myself, "I'm a good guy. I'm entitled to the dessert or beverage I desire. But when I consider my long-term objectives, I realize that staying alive, losing weight, and living a longer life are more crucial.
for my little ones. It is a wise choice to consider both sets of objectives because, if I only act in terms of my short-term objectives, I run the risk of causing long-term harm to myself.
Does it avert considerable conflict with others? is the fourth test. This is less true when it comes to eating because, unlike with alcohol or drugs, I rarely have interpersonal problems when I abuse food. But if you keep gaining weight, consider how you'll be able to interact with your friends and grandkids. And what about disagreements with oneself? Everyone is aware of what they have done. You are aware even if the meal vanishes and nobody saw you consume it. What do you think of that?
Does it help me feel the way I want to feel? is the fifth and final test. "Will what I'm putting in my mouth make me feel better?" is a question I can ask. If it's sugar or booze, it might work in the short term. What about the subsequent crash, though? Is this the option that will help you feel the way you want to feel?
The Five Tests for Rational Beliefs are a checklist.
After you've written down your ideas, compare them to the following list.
Is it genuinely accurate?
Does it benefit my physical well-being?
Are my current thoughts in line with my short- and long-term objectives?
Does it avoid major disputes with others?
Does it support my desired feelings?
The foundation for responsible behavior is these five criteria for reasonable thought. Realistically, you might be able to defy your beliefs for a while, but if you don't alter the way you think, eventually your actions will follow your thoughts. I'm sure you can see,
The most important thing here is being truthful to yourself. You can and will succeed if you examine your thinking, analyze it, challenge it using these principles, practice the new way of thinking, and put up with discomfort during the transition time. However, your odds of success decrease if you determine that you are being forced to do something you don't want to do. If you turn changing your way of thinking into a "have to" duty rather than a "want to," then you are less likely to succeed. Next, we'll examine the "have to" mentality.