Q. Can I use artificial sweeteners to flavor my water? 

A. Artificial sweeteners like splenda, aspartame, and sucralose that are found in Crystal Light and Propel can be diluted and used sparingly to spice up your water. Do be aware that artificial sweeteners are known to be potent appetite stimulants. Another option is to use lemon or lime squeezes, as well as sliced cucumbers.

Q. If a particular food I consume doesn’t settle well and I vomit it back up, what should I do?

A. If vomiting is a consistent pattern, please call our office at (801)-268-3800. If the vomiting is a one time episode, do as follows: Put your fork down, do not take another bite, and do not drink water for 30 minutes. 

At that point, it is recommended to do a liquid diet for about 1-3 days, varying on the severity of the episode. Write the culprit food down in a journal and it is best to avoid that food for a couple of weeks. As you reintroduce yourself to a regular diet, remember to chew very thoroughly and make sure the prepared food is moist. 

Most common food culprits? Eggs and chicken breast. When eating these particular choices, take extra care: check moisture and chew each pea-sized bite 10-15 times.

In the spirit of the upcoming holiday- let us give thanks! Bring your own success story to share and learn from others’ life changing experiences. Meredith Mangum, RN will be leading the discussion.

Salt Lake City: 11/11/09 St. Mark’s Hospital, Room G04C @ 6pm

Ogden: 11/10/09 Ogden Regional Medical Center, Oak Room @ 7pm

Orem: 11/4/09 Timpanogos Regional Hospital, Women’s Center Classroom @ 7pm

October’s support group has come and gone, but we hope the inspiration gained and information learned has stayed with you. The topic for the month was Vitamins and Minerals, with the discussion led by our three surgeons. Dr. Smith attended Orem, Dr. McKinlay visited Ogden, and Dr. Simper remained in Salt Lake. 

Topic: Vitamins and Minerals. The hope was to remind you what supplementation is needed, and WHY it is needed. We have 30 years of good data on gastric bypass patients specifically, and those who supplement do not have deficiencies. So, as a reminder, our recommended supplementation regimen is as follows:

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.

Not only was it a successful discussion on the assigned topic, but it was a good chance for our patients to connect with one another and get answers to questions that have arised since last month’s support group. I was able to attend to Salt Lake City’s group and so enjoyed meeting with our patients on a more personal level.

Look forward to seeing you next month! I need everybody’s participation, as the topic for November is:

            Success Stories. Bring your own success story to share and learn from others’  life changing experiences.

As we approach the colder months of fall and winter, flu season will be kicking into full swing. October 2009 has already seen record numbers of flu cases in doctor’s offices. We would like to remind you that the H1N1 flu is still something of which to be aware.

With simple precautions, we can reduce the spread of the influenza to others.

If you are experiencing signs such as a sore throat, cough, fever (but not always present in H1N1), and muscle soreness you should limit your exposure to others.  With the exception of visits to your primary care physician, or the hospital, you should reschedule non urgent visits outside your home.

Visits to our office should be rescheduled if you are experiencing the above symptoms.

A new website has been established to better guide you if a visit to see your primary care doctor is necessary and if you should stay home from work/school:

        Flu.gov 

If you are still unsure if you should reschedule your Rocky Mountain Associated Physicians appointment or not, please don’t hesitate to contact our office at (801) 268-3800.

Make sure to wash your hands frequently throughout the day, and/or carry hand sanitizer with you. Remember, that after 10 consecutive uses of hand sanitizer, it is no longer effective and a hand wash is necessary. Drink plenty of water throughout the day, get adequate rest (8 hours/day), and eat properly.

Time to take care of you and yours!

Q: Can hair loss occur after weight loss surgery?

A: Yes. Most commonly hair loss happens around months 3 or 4 postoperatively, but that can vary. It does stop and it does grow back. Rest assured, you will not go bald. The patient is the one who notices their own hair loss the most; we are our own worst critic.

No remedy is thoroughly scientifically proven, but some patients swear by biotin, niacin, or gelatin capsules to abate hair loss. As long as you are eating adequate amounts of protein (40-60g/day), the hair loss is stemming from the body’s way of shedding itself while maintaining the most vital organs (the ones inside you!).

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!