This upcoming weekend, Team RMAP will be traveling to St. George, Utah to run the annual marathon on October 3rd, 2009.

As we like to practice what we preach, there are several RMAP staff members and a patient who will comprise and represent Team RMAP. We would like to congratulate, in advance, the following:

Dr. Rod McKinlay (Surgeon)
Dr. Joanna Erzinger (Dr. Simper’s wife)
Meredith Mangum, RN (Education Director)
Karen Mangum, RD (Meredith’s mother- celebrating her 51st birthday!)
Eric Oscarson (Patient)

Anyone in the St. George area, or anyone willing to make the trip to warm weather (fingers crossed…), is welcome to cheer on Team RMAP as they embark on the 26.2 mile race!

Good luck to those running!

For the month of October, the RMAP surgeons will be attending the support groups to discuss the importance of vitamin and mineral supplementation!

Orem: Dr. Sherman Smith

         Wednesday, October 7th @ 7pm, Timpanogos Regional Hospital, Women’s Center Classroom

Ogden: Dr. Rod McKinlay

          Tuesday, October 13th @ 7pm, Weber County Library (Pleasant Valley Branch) 5568 S. Adams Ave.

Salt Lake City: Dr. Steven Simper

           Wednesday, October 14th @ 6pm, St. Mark’s Hospital, Room G04C

Rock Springs, WY: October 15th @ 7pm, White Mountain Library, 2935 Sweetwater Drive

Please note the location of the Ogden support group; it has changed just for the month of October due to a timing conflict at Ogden Regional Hospital.

Hope to see you there!

Q: I have been at the same weight for a while now; what am I doing wrong?

A: If you are following the guidelines in your RMAP Binder, do not be discouraged! This is most likely a natural stall during your weight loss journey. To consider weight loss at a plateau, you usually stay at the same weight for about 6 weeks. Anything less than 6 weeks (if you are following the rules…) is the body’s own way of shedding itself. Weight loss does not maintain a consistent downhill pattern; weight loss ebbs and flows, vacillating between minor stalls and losses.

If you maintained a certain weight prior to WLS, it is not uncommon for the body to want to stay there on its way down, as well. As you should be exercising, you may be gaining muscle weight (which weighs more than fat) while losing fat. The number on the scale may be the same, but your clothes may be fitting more loosely.

Remember, you didn’t gain the weight overnight, so you are not going to lose it overnight either. Enjoy this journey!

Q: What is the importance of drinking adequate daily water?

A: The magical number we recommend as a minimum intake for the day is 64 ounces (8 cups) of water, but we prefer you to be well above that. Water helps with a multitude of ills: Dehydration, nausea, hunger, low energy or fatigue, kidney stones. When encountering a physical or emotional difficulty post weight loss surgery, often our answer will be to you is: Drink more water!

Bored with the bland taste of H20? There are ways to spice it up! You can try adding diluted sugar free flavoring to your water, like Crystal Light, or Propel. Do be aware that artificial sweeteners can increase your appetite. You can try squeezing lemon or lime juice into your water, or adding sliced cucumbers.

Cheers!

Q: What are the labs required to have drawn annually post weight loss surgery?

1. Comprehensive Metabolic Panel
2. Lipid Profile
3. CBC with diff
4. Vitamin B12 level
5. Thiamine (Vitamin B1) level
6. Folate
7. Hemoglobin A1c

What are the labs required to have drawn annually for Duodenal Switch patients?

            All of the above labs, PLUS….

1. Vitamin A level
2. Vitamin D level
3. Protime

The annual Walk from Obesity was held Saturday, August 29^th, 2009 at West Jordan’s Veteran Memorial Park! The focus was on childhood obesity awareness, research, and prevention. We had about 60 participants, including several members from RMAP: Bette (Receptionist), Paula (Patient Advocate), Alicia (Dietitian), and Dr. McKinlay (Surgeon, duh!).

Best of all, we had many patients attend. A BIG shout out to those who gave up their Saturday morning to participate in this important event! We thank you!

Alicia had the following to say about the event,

“It was fun! Lots of kids and kid activity. I have a few ideas for next year to help us be more interactive with the population that will be there such as nutrition and activity games.”

Of course there are always things we can improve upon. The committee will be meeting at the end of September to discuss the Walk and to start planning for next year! We hope to make this an event that people will put on their calendar as something to look forward to! 

All proceeds from the event will go to the American Society of Metabolic and Bariatric Surgery (ASMBS), as well as the Obesity Action Coalition (OAC) for obesity research.

Come on ya’ll, let’s not just talk the walk, but walk the walk!

Q. What vitamins and minerals should we take pre- and post-operatively?

A. 1) Multivitamin: One/day, we don’t recommend a certain brand, but do know that Centrum is a popular one amongst our patients. For about two weeks after surgery, this pill should be chewable or liquid. Taking children’s vitamins is okay, as long as you take two pills (or the recommended adult dose as indicated on the bottle). Using a gummy bear multivitamin is okay, but do be aware of extra added sugar. Take it at a time that can become habit for you.

2) Vitamin B-12: 500-1,000 mcg/day. Take sublingually (a small pill that is placed under the tongue and absorbed directly into the bloodstream) daily or by intra-muscular injections, monthly. Take at a time that can become habit for you.

 3) Calcium: 1,200mg (pre-menopausal) — 1,500mg (post-menopausal) daily, but it is best to take in smaller doses 3x/day. Hence, 400-500mg 3x/day (at each meal). Do not take your calcium supplement until you are drinking at least 64 ounces of water. For the first two weeks after surgery, this pill will need to be chewable. Calcium Chews are okay to use, but be aware of any extra added sugar.

4) Iron: This may be prescribed by your surgeon at a later date, if needed. Usually only needed by menstruating women. Take at a time that can become habit for you, but with one stipulation: Iron must be taken at least 2 hours apart from the calcium supplement. They compete for absorption sites.

Q. What should I do to treat constipation?

A. A normal bowel movement is defined as once every three hours to once every three days. If you are outside this time frame, and are not experiencing severe abdominal pain, here are your options:

1) Drink plenty of water; at least 64 ounces, preferably more.

2) Physical Activity: Get up and move! Exercise! This stimulates peristalsis (movement of the GI tract). So get that heart rate up!

3) Use an OTC (over the counter) laxative, such as Colace or Milk of Magnesia. This should not be used regularly, but in times of “desperate need.”

4) Occasionally add a little bit of simple sugar to your diet. “A little bit” is    defined as the size of a strawberry, twice a week. Simple sugars can include     fruit or applesauce.