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How to Decide if LAP-BAND® is Right For You

Sunday, December 13th, 2009

Weight loss help

Diet and exercise alone may not be delivering the results you desire. If you struggle with being overweight, you should consider the unique way that weight loss surgery may help you achieve your weight-loss goals. As you compare your options for fighting obesity, the team at Lap Band Rockies would like to make you aware of the many benefits the LAP-BAND® procedure has to offer and help you decide if this method is your ideal choice.

Here are a few suggestions to help you evaluate this increasingly popular weight-loss option:

Have Realistic Expectations — The pounds won’t fall off immediately after surgery. Remember that long-term success with LAP-BAND® requires your commitment to following a nutrition plan and keeping up with fitness routines.

Remember That Everyone Loses Weight Differently —Weight loss tends to occur gradually as you burn calories at a faster rate than you consume them. The patients who will see results more quickly are those who restrict their diet while simultaneously improving fitness.

Commit to Lifestyle Changes — Our nutritionist will work with you to design a diet plan that is comfortable and meets all your nutritional requirements. After weight loss surgery, LAP-BAND® patients do not need to attend boot camps or become instant athletes — walking is the most common fitness activity among our patients (or the elliptical machine for patients with knee and joint problems).

Schedule a Consultation — Only an experienced LAP-BAND® surgeon can give you the green light for surgery. First, visit our Candidate Profile page to research the qualifications for LAP-BAND, and view our weight loss surgery photos. Then set up an appointment with Dr. Kirshenbaum to discuss whether or not this surgery is right for you.

Find out if the LAP-BAND® procedure is is a good option for you to accomplish significant weight loss. To learn all you can about the benefits of surgery and get information on weight loss surgery cost, please contact Dr. Gerald Kirshenbaum at Lap Band Rockies to set up a one-on-one consultation.

— Lindsey Kesel, Bariatric Consultant

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The True Cost of Obesity (and How Weight Loss Surgery Can Help)

Tuesday, December 1st, 2009

If you are severely overweight, you may often be judged on your size, even before you actually interact with people. But the true cost of obesity goes far beyond appearance issues. In addition to the unwanted stares and lack of self-confidence that come with obesity, extra pounds can have serious health implications, as well.

Obesity Defined

Obesity is a condition of being substantially overweight, defined by most doctors as having a Body Mass Index (BMI) of 40 or greater, or a 35 or greater with associated health conditions such as hypertension, sleep apnea, joint pain, or a 30 with Type II diabetes.

A Costly Condition

The Centers for Disease Control and Prevention reports the last comprehensive medical spending study done by the National Health Interview Surveys (NHIS), with estimated costs of obesity totaling $47.5 billion! Obesity can rob you of your self-esteem, inhibit your personality, and put your body in danger.

LAP-BAND® as a Smart Investment

The LAP-BAND® procedure is one way men and women are taking a stand against obesity. Compared to the true cost of obesity, the financial cost of LAP-BAND® is a small price to pay for your physical and emotional wellness. A skilled LAP-BAND® surgeon will discuss all the benefits of this procedure and show you how it has helped past patients improve their quality of life.

Weight loss via the LAP-BAND® procedure can help you improve serious health conditions, make you more mobile and active, increase your energy, and help limit calorie intake. Plus, our post-surgery guidance and planning program makes it easy to keep the weight off over the long term. Nutritional counseling allows you to structure your meals and teaches you how to eat so your body uses calories more efficiently.

To learn more about the LAP-BAND® procedure and how it can help you escape the hardships of obesity, contact Dr. Gerald Kirshenbaum at Lap Band Rockies today.

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Do You Need a LAP-BAND® Adjustment?

Monday, October 26th, 2009

The great thing about the LAP-BAND® procedure is its versatility. Dr. Kirshenbaum can adjust the band to fit your individual needs and to maximize its weight-loss effects. You may need a band adjustment when:

  • Your weight plateaus and everything else is truly the same.
  • The same amount of food no longer satisfies your hunger.

Your First Adjustment

Your first adjustment is usually done four weeks after surgery. Kirshenbaum will discuss with you what size of band you have at your post-op appointment. We will also provide you with a post-op packet of information that will come with an identification card once you register your band online they will send you a permanent identification card.

How Much of a Fill Is Needed?

Every patient is different; there are different size stomachs and different amounts of fat surrounding each stomach. Just because one patient has a fill of 2.5cc and is losing weight at that level of fill does not mean that it is the magical number that will work for another.

How Many Fills to Get It Right?

Dr. Kirshenbaum’s approach is to add fluid until you have restriction and then back off by 0.1 ml. He does not limit any one fill to any specific amount. He wants you to have a effective fill every time you do a fill with him. It may require 3-4 fills before you’re actually at what we call the “sweet spot.” The body changes as the patient loses weight, so the fill volume that is right today may not be right after the patient has lost another ten pounds. In weight loss, everything gets thinner, including the stomach.

The right restriction is one that permits eating roughly a third of pre-surgery solid intake. A band that is too tight will not permit eating solids, and you will be forced to consume mushy foods and liquids which will not allow you to lose weight optimally.

The Days after the Fill

Once the fill has been performed, the band will be tighter. You will not feel it, of course. The urge to eat the same amounts at the same velocity will be there, but the ability to do so will not. Typically, due to inattention, you may ingest food that has not been chewed well enough. When this occurs, you will often experience PBing, or Productive Burping. This is not a burp, but a regurgitation of food that backs up into the mouth from the lower esophagus.

Scenarios: When a Fill May Not Be Needed

Reflux Symptoms

Reflux symptoms are caused by inflammation of the esophageal and/or stomach lining and usually occur after you have recently had an adjustment, or there has been an episode of food dislodging, PBing, and vomiting. Treatment for this is a self-imposed liquid diet. If the symptoms do not resolve or are clearly related to the fill, you must contact the doctor to arrange an unfill.

Band Tightens and Loosens During the Day

Typically, the band is tighter in the morning. Acid contact during the night can cause temporary thickening of the lining and, thus, greater restriction. Keep away from extremes such as very hot or very cold foods that can trigger esophageal spasm and further prevent you from eating an adequate breakfast. Some banded people cannot eat for a number of hours after rising, no matter if they drink hot liquids or not.

The fill is a vital part of band management and you need to be aware of the correct tightness at all times. Also, the fill is an essential part of the overall success of weight loss journey and need attention by your doctor to reach the goal you want to achieve.

Get all the facts on the LAP-BAND® adjustment process when you schedule your consultation at Lap Band Rockies in Denver.

Check back next week for our blog on LAP-BAND® pre- and post-adjustment instructions.

—Lindsey Kesel, Bariatric Consultant

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Pre-Surgery Checklist for LAP-BAND® Patients

Sunday, September 13th, 2009

During the weeks before your LAP-BAND® procedure, you should be preparing yourself mentally and physically for the changes your body will be undergoing. Before your Dr. Kirshenbaum performs the procedure, there are steps you can take to get ready for life with a LAP-BAND.®

Use this checklist as a guide to help you get ready for the big day.

__Pre-Operative History and Physical: During your initial consultation, you will schedule a physical examination with the surgeon to make sure you are a good candidate for LAP-BAND.®

__Nutritionist Consultation: You’ll then meet with an experienced nutritionist to assess your dietary needs and create a long-term plan.

__Pre-operative Diet: You’ll work with the nutritionist to institute a customized diet that will begin anywhere from seven to 14 days before your surgery. The diet start date will be based on your Body Mass Index — as a rule of thumb, if your BMI is under 40, the diet will start one week prior to surgery. If your BMI exceeds 40, you will be instructed to begin 2 weeks before surgery. You’ll need to avoid bread, rice, pasta, potatoes, and anything with white flour (pretzels, tacos, cupcakes, cookies, etc.).

__Payment in Full: At Lap Band Rockies, payment is requested a minimum of 14 days prior to surgery.

__Prescriptions: Be sure to fill your post-op prescriptions before surgery — Dr. Kirshenbaum will give you those scripts during the pre-op appointment, along with a list of over-the-counter medications that you should avoid.

__Post-Operative Diet: Purchase items you need to have during your clear and full liquid phase of the diet. (Dr. Kirshenbaum recommends room temperature and cold liquids for one week following surgery.)

__Post-Operative Appointment: Schedule your post-op appointment before surgery day. If you are an out-of state patient this appointment is not required. During your post-op appointment, you will schedule your first fill appointment.

__Group Support: Attend support group meetings at our office the first Monday of the month or use the support groups that are available online.

__Steps of Surgery: Speak with your surgeon about what happen during our surgery.

__Ride Home: Ensure that you have someone drive you home after the surgery and also arrange for someone to take care of you after the surgery.

__Recovery Planning: Plan to be off work and resting during the recovery period. Normally, a four-week break from any strenuous lifting is advised.

Get more in-depth information about the changes you’ll need to make to set you up for a successful LAP-BAND experience. Please contact Dr. Gerald Kirshenbaum at Lap Band Rockies in Denver for a one-on-one weight loss surgery consultation.

—Lindsey Kesel, Bariatric Surgery Consultant

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Behavior Modification Following LAP-BAND® Surgery

Tuesday, September 8th, 2009

Thousands of Colorado residents have enjoyed weight-loss success after the LAP-BAND® procedure. But the road to significant, stable body fat reduction requires your active participation.

Following the LAP-BAND® surgery, your surgeon will inform you of your responsibilities and help you create a plan to achieve and maintain long-term results. Below, we’ve listed some generalized behavior modification suggestions to give you an idea of the changes that are optimal after the insertion of the LAP-BAND® system. Keep in mind that every body is unique, so each patient’s recommended lifestyle changes will be highly personalized.

Recommended Lifestyle Tips Following LAP-BAND®:

  • Exercise: Your new LAP-BAND® will not limit you physically. Most patients are encouraged to participate in a variety of exercise types, including cardiovascular fitness, stretching, strength training, and core/balance exercises.
  • Nutrition: Remember that your new Band will help create a feeling of fullness sooner, so you’ll eat less at each sitting. You also should make sure everything you eat has nutritional value, avoiding “empty” calories as much as possible. Your personal nutritionist will give you detailed nutritional guidelines to help you ensure you are practicing good portion control and getting the nutrients you need.
  • Supplements: While it is possible to get the required daily nutrition from your daily meals, we recommend that you take multi-vitamins to keep up with important levels of things like Iron, B-vitamins, and minerals like Zinc.
  • Medication: Most patients are able to continue with any prescribed medication they are currently on, such as birth control pills, blood pressure medication, insulin, and others. Generally, it is suggested that LAP-BAND® patients crush all pills to ensure safe swallowing.
  • Portions and Speed: A lot of patients worry about what to do during dinners out or large family feasts. If you go out to eat, order a small portion or split a meal. Chew thoroughly and practice eating at a slow pace. Another trick is to have your waitress box up half your meal and bring you only half at the table.
  • Alcohol: Alcohol in small quantities should not hinder weight loss. However, keep in mind that it has a lot of calories and tends to reduce the effectiveness of vitamins and supplements.

Talk to an experienced LAP-BAND surgeon today about the procedure and how lifestyle changes can help you lose weight and keep it off. Please contact Dr. Gerald Kirshenbaum today at Lap Band Rockies in Denver for a personal consultation.

—Lindsey Kesel, Bariatric Surgery Consultant

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Step-by-Step: A Guide to LAP-BAND® Surgery

Friday, August 14th, 2009

LAP-BAND® is a complex procedure that allows patients to change the way their bodies process food with minimal downtime. The basic steps patients undergo during LAP-BAND® include transportation to the ambulatory surgery center, general anesthesia, and the laparoscopic approach. Gerald Dr. Kirshenbaum of Lap Band Rockies shares the surgical steps involved.

  • I always look for a hiatal hernia and fix it as part of the procedure (at no additional cost) if it’s there.  If it’s not obvious, I have the anesthesiologist pass a calibration tube into the stomach, distend the calibration balloon, and pull back against the hiatus. If the balloon pops through the hiatus, I fix that as well.  This prevents problems in the future.
  • An instrument is passed behind the stomach and the band is introduced into the peritoneal cavity. The tubing is pulled behind the stomach as is the band. This tubing is then passed through the locking mechanism of the band and the unit is locked. I always include perigastric fat under the band to prevent erosion. 
  • Permanent sutures are placed in the stomach over the band to prevent gastric slippage.
  • Then, the tubing is brought out through the same incision as the band went in. A pocket is created to accommodate the port of the band which rest under the skin, under all the fat, and on the fascia. 
  • The incisions are closed with buried dissolvable suture so there’s no need for removal. The site is covered with a plastic occlusive dressing (Op-Site or Tegederm) so the patient can shower the next day.
  • After the procedure, patients recuperate in the Recovery Room for an hour, then head over to the the Sit-Up area for another hour. Most patients are released from the Surgery Center at this point. I will see each patients at the one-week mark (if you are a local resident). Out-of-town patients can come in for a follow-up visit the day after the surgery if desired. 
  • The first fill of the band is done at one month following the surgery but can be done later if your schedule requires more time after the surgery.

To discuss the LAP-BAND® procedure and find out if you are a good candidate for the procedure, please contact Dr. Kirshenbaum at Lap Band Rockies. 

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Tips for Finding a LAP-BAND® Surgeon

Monday, July 27th, 2009

The decision to have weight-loss surgery is an important one that requires careful consideration and evaluation of your body goals. Finding the right LAP-BAND® surgeon can not only make a difference in your results, it can make the whole process a positive one.

It can be challenging to choose an experienced LAP-BAND® surgeon, especially with all of the competitors claiming to deliver great results and personalized care. In order to make an informed decision, you should meet with weight-loss professionals in person to get a feel for how a practice really treats its patients. Below are a few additional suggestions you can use to help you narrow down your list and select the LAP-BAND® provider that is right for you.

  • Make sure the surgeon you choose to perform your procedure has many years of experience and a strong medical background.
  • Talk to your neighbors and friends for recommendations, or visit online weight-loss forums for information about surgeons, the procedure itself, and follow-up steps.
  • Make sure the surgeon that you choose explains exactly how your weight-loss surgery will work in detail, as well as all of the risks of LAP-BAND®.
  • Ask the physician to share past results with you, including patient success stories.
  • Choose a weight-loss practice that will thoroughly explain the fees for LAP-BAND® surgery, and one that offers the option to finance your procedure.
  • Choose a LAP-BAND practice that has a comprehensive follow-up plan to monitor your progress after surgery and provides its patients with a wide variety of weight-loss resources.
  • Find a LAP-BAND team that includes a skilled nutritionist to assist you with a dietary plan.

Remember to trust your instincts and ask as many questions as you need to choose a doctor that is perfect for you. To find out what makes Lap Band Rockies a favorite weight-loss surgery destination in Colorado, please contact Dr. Gerald Kirshenbaum to set up a personal consultation.

—Lindsey Kesel, Bariatric Surgery Consultant

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How to Prepare for LAP-BAND® Surgery

Friday, July 17th, 2009

Getting ready for major surgery can be a nerve-wracking process. But with careful preparation and guidance from a highly skilled weight loss surgeon, you can go into your procedure with peace of mind and complete confidence. LAP-BAND® surgery is an experience that can change your life. It is important to stay positive, commit to the steps necessary to become successful, and look at a long-term plan for staying healthy after surgery.

Here are some things you can do to get ready for surgery and set yourself up for success:

  • Learn all you can about the LAP-BAND® procedure through Web research, physician information, and talking to other LAP-BAND® patients.
  • Make a list and have your weight loss surgeon answer all your questions about LAP-BAND®.
  • Study the risks of LAP-BAND® carefully and talk to the surgeon about any areas of concern.
  • Make sure you meet the candidate qualifications for LAP-BAND®.
  • Talk to a qualified nutritionist about the dietary requirements necessary before and after the LAP-BAND® procedure.
  • Review a few patient success stories for motivation and inspiration.
  • Use a variety of weight-loss resources to review others experiences and better understand the effects of surgery.
  • Make sure you have realistic expectations of what weight loss surgery can and cannot do for you.

Remember that losing weight and keeping it off is a gradual process that requires continuous effort and attention. To learn more about how you can prepare for surgery and understand your responsibilities, please contact Dr. Gerald Kirshenbaum at Lap Band Rockies in Denver, Colorado.

—Lindsey Kesel, Bariatric Surgery Consultant

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The Effects on Marriage after Weight-Loss Surgery

Saturday, July 11th, 2009

Significant weight loss can have profound effects on a marriage and interpersonal relationships in general. The normal dynamic between husband and wife can be altered after one partner undergoes a weight loss producer like LAP-BAND®. 

At the inception of the relationship, one member of the marriage may have been overweight. At the time, this may have been completely acceptable to the other party; indeed, it may have been desirable. For example, if one individual is of normal body build and the other is overweight, the normal partner may feel more secure that his or her mate will not be attractive to another suitor. It might be perceived that the overweight individual values the relationship even more because of issues of negative self-worth.

During the pre-operative period, an apparently supportive partner may become less helpful after the surgery due to fear of losing some control over the successful weight-losing spouse.

When the overweight partner loses weight and becomes attractive by normal standards, this may create an unstable situation in the marriage. The spouse may be concerned that the now attractive partner will attract attention from others. If there has been any type of ongoing conflict in the relationship, certain behaviors which may have been tolerated before the weight loss may no longer be acceptable to the partner who has succeeded at weight loss. Divorces have resulted from such deteriorated relationships.

It is therefore important for both parties to understand the dynamics of their relationship and how these may change during the process of weight loss. An understanding of these shifts in the relationship can lead to mutual support and respect, resulting in a partnership that is ultimately strengthened.  

Lap Band Rockies, one of Colorado’s most experienced weight loss surgery destinations, offers a regular support group, guided by Susan Silver, PhD in Counseling Psychology, which meets each month to discuss these types of issues.

If you would like to learn more about what LAP-BAND® can do for you and the lifestyle changes that can happen, contact experienced LAP-BAND surgeon Dr. Gerald Kirshenbaum for a consultation.

—Lindsey Kesel, Bariatric Surgery Consultant

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Weight Reduction – A Man’s Point of View

Sunday, June 28th, 2009

Obesity affects men and women of all ages and backgrounds. Since the benefits of large-volume weight loss are most often discussed from a woman’s point of view or targeted specifically towards women, we wanted to touch on how the LAP-BAND® procedure can improve health and happiness for men, as well.

In their many years of performing state-of-the-art weight loss procedures, the team at Lap Band Rockies has helped countless men reach their weight loss goals.  Here they share the following observations regarding men and how they view the comprehensive weight loss procedure experience:

  • In general, men are more interested in resolution of co-morbidities (hypertension, diabetes, sleep apnea, joint pain) rather than the appearance benefits.  Looking good is still important but not usually the primary goal of our male patients.
  • Our male LAP-BAND® recipients are often very keen on the financial sense the procedure provides. When you look at our past patients and read through the success stories, it is clear that the procedure is a smart financial decision. Recent statistics show that the LAP-BAND® procedure can essentially pay for itself within 14 months (assuming $9950 is the cost). Our patients enjoy saving money on food, co-pays on medicines, doctor visits, ER visits, hospitalizations, etc. And, the fact that third-party financing is available makes this procedure affordable.
  • Men appreciate the fact that weight loss can help them build confidence and feel more comfortable in social situations. One patient in particular remarked how differently he is treated at work now then when he was overweight. He said that before there were very few people who would give him the time of day and now that he has lost the weight, even though his personality has not changed, he is treated with more respect. In another instance, a patient had a hard time finding a date until he had lost weight which he felt made him more approachable and more willing to engage the opposite sex.
  • Many of our patients appreciate the fact that they become more mobile and active after surgery. A number of our male patients have described the after effects of LAP-BAND® as “getting their life back.”

Discover how weight loss surgery can help you in so many wonderful ways. If you have questions about LAP-BAND and you would like to find out if you are a good LAP-BAND® candidate, set up a consultation with Dr. Gerald Kirshenbaum today at Lap Band Rockies.

 

—Lindsey Kesel, Bariatric Surgery Consultant

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